Later Age Of Menarche Research Articles

Association of Age at Menarche with General and Abdominal Obesity in Young Women.

Background and Objectives: Age at menarche is related to various biological and socioeconomic factors in childhood. The aim of the study was to examine the association of age at menarche with general and abdominal obesity in young women. Materials and Methods: A transversal anthropometric survey was conducted with 102 females from 21 to 25 years of age. The surveyed traits included height, weight, waist circumference (WC) and hip circumference (HC). General obesity was assessed using the body mass index (BMI) and abdominal obesity by WC, waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR). A retrospective method was used for collecting age at menarche data. Results: The average age at menarche is 12.80 years. Early menarcheal age (<12 years) is detected in 25.5% of young females, while late onset of menarche (>14 years) is recorded for 20.6% of subjects. Early menarche age subjects exhibit significantly higher BMI, WC and WHtR in comparison with their late menarche age peers. There is a significant negative correlation between BMI, WC and WHtR values and menarcheal age. Late age at menarche is associated with higher probability of underweight status (BMI < 18.5 and/or WHtR < 0.4). Conclusions: Age at menarche has a negative correlation with general and abdominal obesity. Young women with early age at menarche show statistically higher values of BMI, WC and WHtR, while those with late menarcheal age show greater susceptibility to becoming underweight.

Age at Menarche and Its Association With Adult-Onset Metabolic Syndrome and Related Disorders in Women: A Cross-Sectional Study of a Nationally Representative Sample Over 10 Years.

The prevalence of metabolic syndrome (MetS) as well as related social costs and efforts is increasing. The purpose of this study was to investigate the association between age at menarche and the risk of MetS, obesity, diabetes, and cardiovascular disease (CVD) in women over 30 years, using data from the Korean National Health and Nutrition Examination Survey (2010-2020). The analysis of 30 916 participants showed that early menarche (before 11 years) significantly increased the risk of obesity, diabetes, and MetS compared with the median age of 14 years. Late menarche (after 17 years) was also linked to MetS and related disorders. The relationship between age at menarche (at <10 years and >19 years) and the risk of MetS and related disorders exhibited a reversed J-shaped (し) pattern characterized by a pronounced increased risk among those who experience early menarche, whereas the increased risk associated with late menarche was less consistent. These results will help to decrease the risk of MetS and related disorders by enabling early intervention in early and late menarche age groups.

P-726 Age of natural menopause and its associated factors among ethnic Han and Tibetan Chinese women: findings from a China Multi-Ethnic Cohort (CMEC) study

Abstract Study question Is there a disparity in the age of natural menopause (ANM) between ethnic Han and Tibetan Chinese women? Summary answer The present study has discovered a significant difference in the ANM between ethnic Han and Tibetan Chinese women. What is known already The ANM indicates the termination of ovarian function and the reproductive lifespan of the ovary. Factors influencing ANM include genetic, ovarian diseases or surgery, environment, and unhealthy lifestyles. Some studies reported that ANM was different among different ethnics, such as lower in African, Latin American, Asian, whereas higher in Europe, Australia and America. Ethnic Tibetan Chinese mainly resides in an environment with high altitude, low oxygen level, and intense ultraviolet radiation. They also have unique dietary and lifestyle habits, which might result in different ANM compared to ethnic Han Chinese. However, there are few studies on ANM between the two. Study design, size, duration We performed a cross-section study involving 11174 ethnic Han and 1049 ethnic Tibetan Chinese postmenopausal women from Chengdu city and Aba Prefecture in Sichuan province. The participants were recruited by the China Multi-Ethnic Cohort (CMEC) study from May 2018 to September 2019. Participants/materials, setting, methods Information of the postmenopausal women was derived from CMEC baseline questionnaire. Ethnicity was used as the primary exposure variable. Regression models incorporating linear, quadratic and quadratic with interaction terms on age were used to assess the association of ANM with the ethnicity. Main results and the role of chance The mean ANM of ethnic Han Chinese women was later than that of ethnic Tibetan Chinese women (48.50 ± 4.20 years vs. 47.80 ± 4.92 years, P &amp;lt; 0.05). Multivariate linear regression analysis showed a significant disparity in the ANM between the two groups, and sexual life, higher education, no smoking, never experienced severe food shortage, later age of menarche and more times of pregnancy were associated with later ANM (P &amp;lt; 0.05). Furthermore, the quadratic and interaction models demonstrated a significant non-linear association between the ANM and the age at the time of survey. In both groups, the ANM showed a trend of first rising and then declining with the increase of the age at the time of survey Notably, among women younger than 68, the ANM of ethnic Han Chinese was significantly later than that of ethnic Tibetan Chinese. Limitations, reasons for caution The information regarding menopausal women, including ANM and potential influencing factors were obtained from self-reports. Additionally, the duration of exposure to these potential influencing factors remained uncertain. Wider implications of the findings This is the first study with a large sample size comparing ANM between ethnic Han and Tibetan Chinese women. Notably, the age at the time of survey and ethnicity have independently contributed to variation in ANM, and significant interaction effects on ANM are found between age of survey and ethnicity. Trial registration number not applicable

Early Menarche as a Protective Factor Against Cardiovascular Events: A Systematic Review and Meta-analysis.

Women are often neglected in cardiovascular health prevention. Age at menarche (AAM) has been linked to cardiovascular (CVD) disease in women and is potentially identified as one of the significant CVD risk factor. However, there is still limited comprehensive evidence addressing this issue. This systematic review and meta-analysis aimed to investigate how early menarche affects the outcome of all-cause mortality, CVD mortality, total cardiovascular disease event, stroke (ischemic, hemorrhagic, and total stroke), and coronary heart disease (CHD). The Cochrane Library, MEDLINE, Embase, ScienceDirect, and Google Scholar databases were searched from March 2013 to March 2023 for cohorts investigating the effect of early onset of menarche on CVD events with a minimum follow-up period of 5 years. Studies that observed specific population and/or included women with a history of CVD at baseline were excluded. The Newcastle-Ottawa scale was used for risk of bias assessment for each cohort included. The data were presented as dichotomous measure using risk ratios. I2 statistics were utilized to evaluate the heterogeneity of presented data. Thirteen cohorts included 18 626 799 female patients with ages ranging from 43 to 62.6 years. These reported 6 estimates each for CHD (5 483 298 patients) and all-cause mortality (1 595 878 patients), 5 estimates each for total stroke (2 941 321 patients) and CVD mortality (1 706 742 patients), 4 estimates each for total CVD events (3 988 311 patients) and ischemic stroke (2 434 580 patients), and 1 estimate for hemorrhagic stroke (66 104 patients). Our study found that events of CHD were significantly lower in early menarche (RR 0.57; 95% CI 0.41-0.78; P <.00001), as well as total stroke (RR 0.51; 95% CI 0.35-0.73; P =.0003), CVD mortality (RR 0.47; 95% CI 0.22-0.98; P =.04), total CVD events (RR 0.44; 95% CI 0.25-0.76; P =.003), ischemic stroke (RR 0.31; 95% CI 0.15-0.61; P <.0008), and hemorrhagic stroke (RR 0.12; 95% CI 0.07-0.20; P <.00001); and insignificantly higher in all-cause mortality (RR 0.90, 95% CI 0.76-1.06, P =.20). In our study, cardiovascular events are lower in women with early menarche; hence, the later age of menarche is a potential risk factor to be considered when assessing CVD risk in a patient. However, our sample characteristics were heterogenous, and we did not consider other female hormonal factors that might potentially contribute to the CVD outcomes observed; thus, further studies are needed to clarify.

Strong evidence supports the use of estradiol therapy for the treatment of vaginal inflammation: a two-way Mendelian randomization study

ObjectiveNowadays, there has been limited Mendelian randomization (MR) research focusing on the causal relationship between estradiol and vaginitis. Therefore, this study conducted a two-way MR study to clarify the causal effect and related influencing factors between them.MethodsAll genetic datasets were obtained using publicly available summary statistics based on individuals of European ancestry from the IEU GWAS database. MR analysis was performed using MR-Egger, weighted median (WM) and inverse variance weighted (IVW) methods to assess the causal relationship between exposure and outcome and to validate the findings by comprehensively evaluating the effects of pleiotropic effects and outliers.ResultsMR analysis revealed no significant causal relationship between estradiol and vaginitis risk. There was a negative correlation between estradiol and age at menarche (IVW, OR: 0.9996, 95% CI: 0.9992–1.0000, P = 0.0295; WM, OR: 0.9995, 95% CI: 0.9993–0.9998, P = 0.0003), and there was a positive correlation between age at menarche and vaginitis (IVW, OR: 1.5108, 95% CI: 1.1474–2.0930, P = 0.0043; MR-Egger, OR: 2.5575, 95% CI: 1.7664–9.6580, P = 0.0013). Estradiol was negatively correlated with age at menopause (IVW, OR: 0.9872, 95% CI: 0.9786–0.9959, P = 0.0041). However, there was no causal relationship between age at menopause and vaginitis (P > 0.05). In addition, HPV E7 Type 16, HPV E7 Type 18, and Lactobacillus had no direct causal effects on estradiol and vaginitis (P > 0.05). Sensitivity analyses revealed no heterogeneity and horizontal pleiotropy.ConclusionWhen estrogen levels drop, it will lead to a later age of menarche, and a later age of menarche may increase the risk of vaginitis, highlighting that the longer the female reproductive tract receives estrogen stimulation, the stronger the defense ability is formed, and the prevalence of vaginitis is reduced. In conclusion, this study indirectly supports an association between reduced level of estrogen or short time of estrogen stimulation and increased risk of vaginitis.

Age at menarche and asthma onset among US girls and women: findings from NHANES, 2001–2018

PurposeTo quantitatively estimate the association of age at menarche with the risk of childhood- and adult-onset asthma separately. MethodsA retrospective cohort study of 24,282 US girls and women was conducted using continuous National Health and Nutrition Examination Survey (NHANES) data from 2001 to 2018, and Cox proportional hazards regression models with censoring ages of 19 and 79 years were employed to separately estimate hazard ratios of childhood- and adult-onset asthma associated with age at menarche. ResultsEach one-year increase in age at menarche was significantly associated with a 16% (hazard ratio [HR] = 0.84; 95% confidence interval [CI]: 0.77-0.91) decrease in the risk of childhood-onset asthma. Compared with age at menarche of 12-14 years, we observed a 56% (HR = 1.56; 95% CI: 1.19-2.04) increased risk of childhood-onset asthma for early menarche (age at menarche < 12 years) and a 40% (HR = 0.60; 95% CI: 0.32-1.10) decreased risk for late menarche (age at menarche ≥ 15 years). No significant association was noted between age at menarche and adult-onset asthma. ConclusionsEarly menarche may represent a risk factor for childhood-onset asthma, which indicates the need for timely and effective management of individuals with early menarche to prevent asthma.

Comparative characteristics of reproductive function in mentally healthy and mentally ill women with infertility

Background. Issues of the relationship and interaction of menstrual and reproductive function and the mental state of women are not sufficiently studied and need additional research.&#x0D; Aim. To conduct a comparative assessment of individual indicators of reproductive function in mentally healthy and mentally ill women with infertility.&#x0D; Materials and methods. Of the 348 women with primary and secondary infertility aged 21 to 40 included in the study, 120 had been treated for a psychiatric disorder in a psychiatric hospital before this study. Patients were clinically evaluated using a specially designed questionnaire card and subsequent statistical processing of the results obtained.&#x0D; Results. The menstrual-generative function of patients in the study groups significantly differed in several indicators. Mentally ill women with primary infertility were characterized by a later age of menarche, menstruation irregularity or absence during the disease exacerbation, scanty menstruations or heavy menstrual bleeding, inadequate emotional response to menarche, and irregularity and dissatisfaction with sexual life. Spontaneous miscarriages and stillbirths were more common in mentally ill women, especially those with endogenous diseases (schizophrenia, affective disorders), and abortions and gynecological operations were more common in mentally healthy women. Predictors of infertility related to mental health were early onset and chronic course of mental disorder, severity and duration of the disease exacerbations, short and incomplete remissions, and personality changes or a defect (schizophrenic) due to mental illness.&#x0D; Conclusion. Menstrual and reproductive functions of women depend on their mental state. In women with mental conditions, menstrual function disorders, along with psychopathological symptoms of diseases (a decrease in sexual vigor, communication, anesthesia of feelings), and decreased social and family adaptation, lead to reproductive function disorders. Improving a woman's mental state can contribute to the recovery of her reproductive function.

Association of Social Determinants of Health, Race and Ethnicity, and Age of Menarche among US Women Over 2 Decades

Age of menarche (AOM), or the first menstrual cycle, is one indicator of female puberty. The timing of AOM can be influenced by social determinants of health (SDOH). This study examined associations between SDOH and AOM over the past 2 decades in the United States. US National Health and Nutrition Examination Survey data (1999 to early 2020) were analyzed. Multinomial logistic regression analyses examined associations between AOM (early [11.99 years and younger], typical [12-13 years], and late [13.01 years and older]) and race/ethnicity, insurance coverage, education, family income-to-poverty ratio, money management, and home status. AOM remained consistent over the past 2 decades (mean 12.50 years, SE 0.02) for the aggregate sample. Females identifying as Hispanic (excluding Mexican Americans) were 63% more likely (adjusted odds ratio [aOR] 1.63, 95% confidence interval [CI] 1.13-2.36) to report early menarche. Those identifying as other/multiracial were 46% more likely to report late menarche (aOR 1.46, 95% CI 1.13-1.89) vs non-Hispanic Whites. Financial and home status instability was associated with early menarche (aOR 1.46, 95% CI 1.17-1.83; aOR 1.25, 95% CI 1.05-1.48). Less than 9th-grade education was associated with late menarche (aOR 1.47, 95% CI 1.14-1.89). Although the average AOM has remained stable in the United States over the past 20 years, identifying as Hispanic (excluding Mexican Americans) and financial/home instability are associated with early AOM, and lower education levels are associated with late AOM. Identifying programming and policy options targeting SDOH may help improve current and future reproductive health.

Association between age at menarche and bone mineral density in postmenopausal women

BackgroundAge at menarche (AAM) directly affects female estrogen levels, which play a vital role in bone metabolism. The exact relationship between bone mineral density (BMD) and AAM remains controversial. Thus, this study aimed to determine the association between AAM and lumbar spine (LS) BMD in postmenopausal women.MethodsOur data were based on the National Health and Nutrition Examination Survey (NHANES) 2011–2018. AAM was divided into three categories including ≤ 12, 13–15, and ≥ 16 years, and the ≤ 12 years old category was used as the reference group. To examine the association between AAM and LS BMD, we used three weighted linear regression models, Model 1 (without adjustment), Model 2 (with adjustment for age, race, and body mass index [BMI]), and Model 3 (with adjustment for all covariates).ResultsThis study included 1195 postmenopausal women aged 40–59 years. In the unadjusted model, a menarche age of ≥ 16 years compared with a menarche age of ≤ 12 years was associated with lower LS BMD (β = − 0.083, 95% CI − 0.117, − 0.048, P < 0.001). After adjusting for potential confounding factors, there was still a negative correlation in model 2 (β = − 0.078, 95% CI − 0.113, − 0.042, P < 0.001) and model 3 (β = − 0.065, 95% CI − 0.096, − 0.033, P < 0.001). Moreover, this significant relationship persisted after excluding participants who used female hormones (β = − 0.053, 95% CI − 0.089, − 0.016, P = 0.006).ConclusionOur study found that postmenopausal women with a menarche age of ≥ 16 years had significantly lower LS BMD than that had by those with a menarche age of ≤ 12 years. As a result of this study, postmenopausal women with a late menarche age may have a higher risk of lumbar osteoporotic fractures and need better bone health care.

Reproductive health data and its relationship to baseline brain imaging and cognitive measurements in cognitively unimpaired female PSEN1 E280A mutation carriers and non‐carriers from the API ADAD Trial

AbstractBackgroundThe impact of sex steroid hormones on Alzheimer’s disease (AD) remains to be further clarified. Research suggests that shorter reproductive span, late menarcheal age, early menopause, oophorectomies and hysterectomies, are associated with increased dementia risk. We examined reproductive health and its associations with brain imaging and cognitive measurements in unimpaired female Presenilin 1 (PSEN1) E280A mutation carriers and non‐carriers from the Alzheimer’s Prevention Initiative Autosomal Dominant AD (API ADAD) Trial (NCT01998841).MethodA total of 151 cognitively unimpaired 30‐53 year‐old females (101 PSEN1 mutation carriers and 50 non‐carriers) were included. Reproductive health data (i.e., menarcheal age, number of pregnancies, deliveries, miscarriages, and living children) from all participants were examined, as well as the extent to which menarcheal age was related to age‐adjusted baseline 1) cortical amyloid plaque burden (florbetapir PET), 2) Precuneus cerebral glucose metabolism (fluorodeoxyglucose PET), 3) hippocampal volume (3TMRI), and 4) the API ADAD preclinical cognitive composite score, which includes the MMSE Orientation score, CERAD Word List Delayed Recall and Constructional Praxis, Multilingual Naming Test and Raven’s Progressive Matrices subset. We examined associations with the cognitive and brain imaging measures corrected for multiple comparisons (Bonferroni).ResultCarrier and non‐carrier females did not differ on number of pregnancies, deliveries, miscarriages, or living children. Female carriers had a significantly younger menarcheal age than non‐carriers (12.8 ±1.5 versus 13.7±1.6 years, p = 0.007, Bonferroni). Among carrier females, older menarcheal age was associated with lower scores on the Raven’s test (Bonferroni: r = ‒0.28,p =0.035). Menarcheal age was not associated with scores on the cognitive composite or other individual subtests, or with brain imaging measures.ConclusionOur findings suggest reproductive health data did not differ between carrier and non‐carrier females, except for a slightly younger menarcheal age compared to non‐carriers, and that menarcheal age may have a very limited impact on brain pathology and function at preclinical stages of ADAD. Longitudinal studies with larger samples are needed to clarify the extent to which earlier menarcheal age may be related to changes in cognitive function in mutation carrier females transitioning from preclinical to clinical stages.

Review of Mendelian Randomization Studies on Endometrial Cancer.

Endometrial cancer (EC) is a common gynecological cancer. In some parts of the world, the incidence and mortality of EC are on the rise. Understanding the risk factors of EC is necessary to prevent the occurrence of this disease. Observational studies have revealed the association between certain modifiable environmental risk factors and EC risk. However, due to unmeasured confounding, measurement errors, and reverse causality, observational studies sometimes have limited ability to judge robust causal inferences. In recent years, Mendelian randomization (MR) analysis has received extensive attention, providing valuable insights for cancer-related research, and is expected to identify potential therapeutic interventions. In MR analysis, genetic variation (alleles are randomly assigned during meiosis and are usually independent of environmental or lifestyle factors) is used instead of modifiable exposure to study the relationship between risk factors and disease. Therefore, MR analysis can make causal inference about exposure and disease risk. This review briefly describes the key principles and assumptions of MR analysis; summarizes published MR studies on EC; focuses on the correlation between different risk factors and EC risks; and discusses the application of MR methods in EC research. The results of MR studies on EC showed that type 2 diabetes, uterine fibroids, higher body mass index, higher plasminogen activator inhibitor-1 (PAI-1), higher fasting insulin, early insulin secretion, longer telomere length, higher testosterone and higher plasma cortisol levels are associated with increased risk of EC. In contrast, later age of menarche, higher circulatory tumor necrosis factor, higher low-density lipoprotein cholesterol, and higher sex hormone-binding globulin levels are associated with reduced risk of EC. In general, despite some limitations, MR analysis still provides an effective way to explore the causal relationship between different risk factors and EC.

Breast Cancer among Young Women in Douala, Cameroon: Epidemiological, Clinical, Behavioural Characteristics and Risk Factors

Aims: This study aimed at determining epidemiological, clinical, behavioural and risk factors for breast cancer (BC) among young women living in Cameroon.&#x0D; Study Design: Cross-sectional case-control study.&#x0D; Place and Duration of Study: The study took place at the Oncology departments of two reference hospitals in Douala (Littoral Region, Cameroon), from July 2020 to July 2021.&#x0D; Methodology: An ad hoc questionnaire form was used to collect data of interest. Anthropometric and bioimpedance parameters were measured. The data were keyed, coded, verified for consistency, and analysed using StatView v5.0 and GraphPad Prism v5.03. Statistical significance was set at P &lt; .05.&#x0D; Results: Of the 276 women initially approached, 176 (88 cases and 88 controls) were finally recruited. They were mainly aged 41-45 years old with higher proportion in controls (40.9% vs 45.4%, P = .0029). The proportion of women having had their menarche at advanced age was higher in cases compared to controls (40.9% vs 12.5%, P &lt; .0001). Visceral adipose tissue (Kg) was significantly higher in cases (8.72 ± 3.04 vs 7.43 ± 2.64, P = .003). Most of the patients were diagnosed at advanced stage, especially at stage 3 (46.6%), with more than one third of them had metastasis. The risk of BC was reduced by 84% (AOR = 0.16, P = .001) in patients having had their menarche after 14 years of age, and 71% (AOR = 0.29, P = .01) in those always consuming fruits/vegetables. In contrast, BC risk was increased in women with familial history of BC (AOR = 3.19, P = .04). Early and late diagnosed BC women had similar characteristics with the exception of age, stillbirth and body mass index.&#x0D; Conclusion: BC is prevalent and detected among young women at advanced stage, with protective role of fruits/vegetables consumption and late age of menarche.

LINEAR GROWTH AND FINAL HEIGHT IN PEOPLE WITH TYPE 1 DIABETES MELLITUS: A STUDY FROM KARACHI-PAKISTAN

OBJECTIVE: To determine the linear growth in children/adolescents with type 1 diabetes mellitus (T1DM) at a tertiary care hospital. METHODS: This observational study was conducted in Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan from January-2001 to July-2021. All children/adolescents diagnosed with T1DM of either gender, between 8-18 years age visiting the outpatient department were included after informed consent. Predesigned questionnaire was developed for data records. Height of study participants and parents was checked in centimeters (cm) by stadiometer and mid-parental height was calculated. Weight was checked in kilograms (kg) on calibrated digital weight machine. Centers for Disease Control and Prevention growth chart was plotted and growth velocity was checked every six months to check linear growth. Final height was compared with targeted height of respective participants. RESULTS: Total of 66 people participated (24 male, 42 female), with mean age at diagnosis was 11.17±4.77 years and duration of diabetes at first visit was 1.97±3.3 years. Mean age at menarche was noted 13.56±1.41 years. The overall height standard deviation score (SDS) at first visit was -0.62±2.58 and at last visit was -1.34±0.94, whereas the overall weight SDS at first visit and at last visit was -0.62±2.58 and 1.34±0.94 respectively. Furthermore, overall mid-parental height was 160.95±10.28 cm and 50% males and 85.7% females achieved genetic target height (p-value=0.002). CONCLUSION: Majority of males did not achieve genetic target height, however females achieved genetic target height along with late age of menarche as compared to general population.

Reproductive factors and gall-bladder cancer, and the effect of common genetic variants on these associations: a case-control study in India.

BackgroundIn India, as elsewhere, the incidence of gall-bladder cancer (GBC) is substantially higher in women than in men. Yet, the relevance of reproductive factors to GBC remains poorly understood.MethodsWe used logistic regression adjusted for age, education and area to examine associations between reproductive factors and GBC risk, using 790 cases of histologically confirmed GBC and group-matched 1726 visitor controls. We tested the interaction of these associations by genetic variants known to increase the risk of GBC.ResultsParity was strongly positively associated with GBC risk: each additional pregnancy was associated with an ∼25% higher risk {odds ratio [OR] 1.26 [95% confidence interval (95% CI) 1.17–1.37]}. After controlling for parity, GBC risk was weakly positively associated with later age of menarche [postmenopausal women, OR 1.11 (95% CI 1.00–1.22) per year], earlier menopause [OR 1.03 (95% CI 1.00–1.06) per year] and shorter reproductive lifespan [OR 1.04 (95% CI 1.01–1.07) per year], but there was little evidence of an association with breastfeeding duration or years since last pregnancy. Risk alleles of single-nucleotide polymorphisms in the ABCB4 and ABCB1 genetic regions had a multiplicative effect on the association with parity, but did not interact with other reproductive factors.ConclusionsWe observed higher GBC risk with higher parity and shorter reproductive lifespan, suggesting an important role for reproductive and hormonal factors.

The mediating effect of skeletal muscle index on the relationship between menarcheal age and bone mineral density in premenopausal women by race/ethnicity.

To examine the contribution of skeletal mass index (SMI) as a mediator in the relationship between menarcheal age and hip/spine bone mineral density (BMD) in premenopausal women by race/ethnicity. The data of 4,329 participants (age ≥ 18; mean age=35.7 ± 9.5) of Whites (n = 2,543), African Americans (n = 1,236), and Asians (n = 550) enrolled from October 2011 to January 2019 from the Louisiana Osteoporosis Study were analyzed. After adjustment for physiological and behavioral factors, multivariable linear regression analyses were conducted to evaluate each component of the proposed mediation models, and mediation was verified by the bootstrapping resampling approach. Premenopausal women with early menarcheal age tended to have higher SMI and BMD than women with normal menarcheal age among all races/ethnicities included. Women with late menarcheal age were, however, more likely to have a lower SMI than their counterparts with normal menarcheal age (r = -0.212, 95% CI = [-0.321 to -0.103] for White women; r = -0.181, 95% CI = [-0.410 to -0.008] for African-American women; r = -0.174, 95% CI = [-0.343 to -0.006] for Asian women). Similar results were found for both spine and hip BMD. SMI fully mediated the difference in BMD due to different menarcheal ages among Whites, African Americans, and Asian women with early menarcheal age; however, no mediating effects were observed for Asian women with late menarcheal age. SMI, as a full mediator, affected the relationship between menarcheal age and BMD among premenopausal women, and the mediating effects varied by race/ethnicity. To prevent or slow down the loss of hip/spine BMD and the development of osteoporosis, measures aiming at minimizing the risk for muscle mass loss should be recommended, especially for White and African-American women with late menarcheal age.

The oracle study - fibromyalgia, prevalence and severity in the hospital setting in the Pakistani population.

To assess the prevalence and severity of fibromyalgia in hospital-visiting patients. The cross-sectional study was conducted at the Pakistan Institute of Medical Sciences, Islamabad, Pakistan, from July, 2018, to January, 2019, and comprised patients aged 18-75 years of either gender. Demographic information, comorbidities and previous medications were recorded for each patient. The modified American College of Rheumatology preliminary diagnostic criteria 2010-11 for fibromyalgia diagnosis. If diagnosed, the fibromyalgia impact questionnaire was administered to assess its severity. Data was analysed using SPSS 25. Of the 750 hospital-visiting patients, fibromyalgia was diagnosed in 250(33.3%); 190(76%) of them being females (p<0.0001). Comorbidities, age and increased elevated body mass index were significantly associated with fibromyalgia. Severity was not influenced by comorbidities, marital status, education or economic status (p>0.05). Menarche at a later age and menstrual irregularity were associated with fibromyalgia severity (p<0.05). The hospital-based prevalence of fibromyalgia was found to be high, especially among females.

IMPACT OF INFECTIOUS DISEASES ON PUBERTAL TIMING IN UKRAINIAN GIRLS: RESULTS A MULTICENTER STUDY

The aim: To determine current age at the initiation of puberty for Ukrainian school-aged girls and infections impact to puberty. Materias and methods: We performed a multicentre cohort study. The analyses are based on data that were collected and evaluated biannually on Ukrainian school girls aged 6-17 years from 5 regions of Ukraine. Pubertal development was classified according to the Marshall and Tanner criteria. Results: Overall, 2,784 girls have been included in the study. Mean age of onset of puberty in Ukrainian girls was 10.1±1.0 yrs. Age of onset of pubic hair was 11.0±1.0 yrs and that of axillary hair was 11.6±1.0 yrs. Mean age in girls of menarche was 12.2±0.9 yrs. There were no significant correlations between age at onset of puberty and body mass index, final height, total peak height velocity, duration of puberty, and peak height velocity. A total of 2,420 infectious diseases were diagnosted. Of these, 64.8% were viral and 35.2% bacterial infections, respectively. Ukrainian girls with infectious diseases (especially viral infections) had older age at pubertal onset and positive association of infections in childhood with late age of menarche. Conclusions: Infectious morbidity (especially viral infections) in girls may be associated with later puberty. The lowering of the number of infections in childhood could be an additional factor that contributes to earlier puberty. To reduce infectious diseases, more attention should be paid to the vaccination of children.

Changes in Volumetric Bone Mineral Density Over 12 Months After a Tibial Bone Stress Injury Diagnosis: Implications for Return to Sports and Military Duty

Background: Bone stress injuries (BSIs) occur in up to 20% of runners and military personnel. Typically, after a period of unloading and gradual return to weightbearing activities, athletes return to unrestricted sports participation or military duty approximately 4 to 14 weeks after a BSI diagnosis, depending on the injury location and severity. However, the time course of the recovery of the bone’s mechanical competence is not well-characterized, and reinjury rates are high. Purpose: To assess the bone microarchitecture and volumetric bone mineral density (vBMD) over 12 months after a tibial BSI diagnosis. Study Design: Case-control study; Level of evidence, 3. Methods: We enrolled 30 female athletes from the local community (aged 18-35 years) with a tibial BSI (grade ≥2 of 4 on magnetic resonance imaging) for this prospective observational study. Participants completed a baseline visit within 3 weeks of the diagnosis. At baseline and 6, 12, 24, and 52 weeks after the BSI diagnosis, we collected high-resolution peripheral quantitative computed tomography scans of the ultradistal tibia (4% of tibial length) of the injured and uninjured legs as well as pain and physical activity assessment findings. Results: From baseline to 12 weeks after the diagnosis, total, trabecular, and cortical vBMD declined by 0.58% to 0.94% (P < .05 for all) in the injured leg. Total and trabecular vBMD also declined by 0.61% and 0.67%, respectively, in the uninjured leg (P < .05 for both). At 24 weeks, mean values for all bone parameters were nearly equivalent to baseline values, and by 52 weeks, several mean values had surpassed baseline values. Of the 30 participants, 10 incurred a subsequent BSI during the course of the study, and 1 of these 10 incurred 2 subsequent BSIs. Participants who suffered an additional BSI were younger and had a later age of menarche, a greater incidence of previous fractures, and lower serum parathyroid hormone levels (P < .05 for all). Conclusion: Bone density declined in both the injured and the uninjured legs and, on average, did not return to baseline for 3 to 6 months after a tibial BSI diagnosis. The observed time to the recovery of baseline vBMD, coupled with the high rate of recurrent BSIs, suggests that improved return-to-sports and military duty guidelines may be in order.

Prevalence of osteoporosis among North Korean women refugees living in South Korea: a comparative cross-sectional study

ObjectiveTo investigate the prevalence of osteoporosis among North Korean women refugees when compared with South Korean women, who have identical genetic backgrounds but experience different environments.DesignComparative cross-sectional study.SettingNorth Korean Refugee...

Female reproductive history in relation to chronic obstructive pulmonary disease and lung function in UK biobank: a prospective population-based cohort study

ObjectivesSex differences in respiratory physiology and predilection for developing chronic obstructive pulmonary disease (COPD) have been documented, suggesting that female sex hormones may influence pathogenesis. We investigated whether aspects of...