Onset Of Menarche Research Articles

FOLLICLE STIMULATING HORMONE LEVEL AS A PREDICTOR OF SPONTANEOUS MENARCHE: A RETROSPECTIVE COHORT STUDY OF 133 PATIENTS WITH TURNER SYNDROME

Onset of spontaneous menarche in patients with Turner Syndrome has been used as a predictor of future fertility potential and for timing of hormone replacement therapy (HRT), but methods for prediction of spontaneous menarche itself is lacking. We sought to evaluate if follicle stimulating hormone (FSH) at the time of hypothalamic pituitary ovarian (HPO) axis activation can predict onset of spontaneous menarche in a racially and ethnically diverse population of patients with Turner Syndrome.

FOLLICLE STIMULATING HORMONE TRENDS IN PATIENTS WITH TURNER SYNDROME ARE ASSOCIATED WITH MORE THAN KARYOTYPE AND SPONTANEOUS MENARCHE STATUS: RACE MATTERS

Longitudinal trends of ovarian reserve among patients with Turner Syndrome have been described in European cohorts; however, data in racially diverse populations are limited. Given that ovarian reserve differs by race and ethnicity in the adult population, we sought to determine the association between trends in follicle stimulating hormone (FSH) levels and karyotype, onset of spontaneous menarche, and race in a longitudinal study of Turner Syndrome patients in a diverse United States population.

Features of pubertal development of adolescent girls with cystic fibrosis

This review is devoted to an urgent and insufficiently studied problem - the characteristics of the pubertal development of girls with cystic fibrosis (CF), the deviations in the period of menarche, the stages of the puberty, anatomical and physiological features of the female reproductive system in this monogenic disease. The increase in life expectancy, as well as the spread and increasing availability of targeted therapies, highlight the need for further research on this topic. Early diagnosis of disorders of pubertal development due to timely prescribed therapy (hormonal) allows not only correcting the timing of the onset of menarche in CF adolescent girls, but also increasing the chances of conceiving and bearing a child.

Confirmation regarding regression polynomial evaluation of age at menarche against age at MPV of weight

Based on the regression evaluation of menarcheal age relative to the age at MPV of height, a delayed menarche evaluation chart was established. In fact, it is thought that the close relationship between menarche and body weight may lie behind the critical weight hypothesis and body fat hypothesis proposed in relation to the onset of menarche. In other words, the age at maximum peak velocity (MPV) in weight and age at menarche are thought to be highly correlated, so a regression evaluation chart for age at menarche against age at MPV of height can be constructed. Then, in the present study, a delayed menarche evaluation chart based on age at MPV of weight is constructed, and compared it with evaluations of delayed menarche determined by age at MPV of height. The results showed that the age at MPV of weight is later than the age of MPV in height. The level of agreement between girls judged using delayed menarche evaluation charts based on ages at MPV of height and weight was analyzed, and the results showed agreement in 131 of 204 girls (64.2%). The fact that there was disagreement in 74 girls (35.8%) indicates that the validity of delayed menarche evaluation based on age at MPV of weight is probably low.

Out of step societal and Darwinian adaptation during evolution is the cause of multiple women's health issues.

During human evolution, major changes in our societal conditions and environment took place without sufficient time for concomitant genetic alterations, leading to out of step adaptation and diseases in women. We first discuss recent societal adaptation mismatch (menstrual bleeding; increases in cancers of reproductive organs, endometriosis; mother's nursing; polycystic ovarian syndrome; transgenerational epigenetic modifications), followed by Darwinian out of step adaptation (labor difficulties; sex chromosomes, human diseases and sex disparity in genomic DNA). We discuss the evolutionary basis of menstrual bleeding, followed by recent increases in cancers of reproductive organs and endometriosis. The importance of breastfeeding by mothers is also emphasized. Earlier onset of menarche, decreased rates of childbirths and breastfeeding resulted in increased number of menstrual cycles in a lifetime, coupled with excess estrogen exposure and incessant ovulation, conditions that increased the susceptibility to mammary and uterine cancers as well as ovarian epithelial cancer and endometriosis. Shorter lactation duration in mothers also contributed to more menstrual cycles. We further discuss the evolutionary basis of the prevalent polycystic ovary syndrome. During the long-term Darwinian evolution, difficulties in childbirth evolved due to a narrowed pelvis, our upright walking and enlarged fetal brain sizes. Because there are 1.5% genomic DNA differences between woman and man, it is of significance to investigate sex-specific human physiology and diseases. In conclusion, understanding out of step adaptation during evolution could allow the prevention and better management of female reproductive dysfunction and diseases.

The effects of obesity on the menstrual cycle

The prevalence of childhood and adolescent obesity has significantly increased in the United States and worldwide since the 1970s, a trend that has been accelerated by the COVID-19 pandemic. The complications of obesity range from negative effects on the cardiovascular, endocrine, hepatobiliary, and musculoskeletal systems to higher rates of mental health conditions such as depression and eating disorders among affected individuals. Among adolescent girls, childhood obesity has been associated with the earlier onset of puberty and menarche, which can result in negative psychosocial consequences, as well as adverse effects on physical health in adulthood. The hormones leptin, kisspeptin and insulin, and their actions on the hypothalamic-pituitary-ovarian axis, have been implicated in the relationship between childhood obesity and the earlier onset of puberty. Obesity in adolescence is also associated with greater menstrual cycle irregularity and the polycystic ovary syndrome (PCOS), which can result in infrequent or absent menstrual periods, and heavy menstrual bleeding. Hyperandrogenism, higher testosterone and fasting insulin levels, and lower levels of sex hormone-binding globulin, similar to the laboratory findings seen in patients with PCOS, are also seen in individuals with obesity, and help to explain the overlap in phenotype between patients with obesity and those with PCOS. Finally, obesity has been associated with higher rates of premenstrual disorders, including premenstrual syndrome and premenstrual dysphoric disorder, and dysmenorrhea, although the data on dysmenorrhea appears to be mixed. Discussing healthy lifestyle changes and identifying and managing menstrual abnormalities in adolescents with obesity are key to reducing the obstetric and gynecologic complications of obesity in adulthood, including infertility, pregnancy complications, and endometrial cancer.

Shorter reproductive life span is associated with increased cardiovascular risk and total mortality in Swedish women from an observational, population-based study

ObjectivesReproductive history of women is of importance to estimate cardiovascular disease (CVD) risk. One aspect of that history is the reproductive life span (RLS), the period between onset of menarche and menopause. Previous studies have indicated an increased risk associated with shorter RLS, but this has never previously been tested in Scandinavian women. Our aim was to investigate such associations in Swedish women. Study designWe used observational data from the Malmö Diet Cancer Study (MDCS), which included 12,101 middle-aged women (mean age 60 years at baseline) born between 1923 and 1945 from Malmö, Sweden. Data on reproductive history was obtained from a questionnaire. Main outcome measuresCox regression was used to estimate the association between quintiles (Q1-Q5) of RLS and incident fatal or non-fatal CVD events and total mortality during follow-up, adjusted for co-variates. ResultsDuring a maximum of 28 years of follow-up, there were 2678 non-fatal CVD events and 5697 deaths. A shorter RLS was associated with an increased CVD risk (hazard ratio (HR) 1.19, 95 % confidence interval (CI) 1.06–1.34, p = 0.004) when comparing Q1 (RLS ≤ 32 years) with Q5 (RLS ≥ 40 years). The association remained significant when specifically controlling for history of hysterectomy and/or oophorectomy (HR 1.20, 95% CI 1.07–1.35, p = 0.002, for Q1 vs. Q5). A shorter RLS was also associated with a higher mortality risk (HR 1.21, 95% CI 1.11–1.31, p = 0.001, for Q1 vs. Q5, and HR 1.10, 95% CI 1.02–1.20, p = 0.02, for Q2 vs. Q5). ConclusionA shorter RLS was associated with increased risk of cardiovascular events and total mortality in Swedish women.

Allergy to airborne allergens and menstrual cycles of women treated for infertility

BackgroundAllergy and fertility problems are important issues. Hormonal status can influence the expression of atopic diseases. ObjectiveThe aim of this study was to assess a connection between sensitization to aeroallergens and the menstruation cycle in infertile women. MethodEighty two women (age range 24–42years, mean age 32.5), treated for difficulties with conception were selected. A detailed history was taken from all patients, including history of allergic diseases. They were physically examined, including gynaecological assessment. All women had skin prick tests with the most important inhalatory allergens (HAL allergy, Leiden, Netherlands). ResultsPositive skin prick tests (SPT) to at least one allergen were observed in 33 patients (40.24%). Grass and rye were the most common sensitizing allergen (22% each), followed by mugwort (19.5%), and house dust mites (14.6%). Correlations between positive SPT and the menstrual cycle were analyzed. The age at the time of the first period is associated with positive SPT for mugwort (P<0.05). OR is 0.638, therefore each year of delay of the first period reduced the risk by 36.2%. Length of the cycle is associated with positivity SPT to Dermatophagoides farinae (P<0.05). OR is 1.133, therefore each additional day of the cycle increased the risk by 13.3%. ConclusionIn this study on women treated for infertility, the global rate of sensitization to pneumallergens is 40%. A statistically significant relationship was found between the early onset of menarche and mugwort sensitization; the length of the cycle and sensitization to Dermatophagoides farinae.

Influence of Menstrual Cycle Length and Age at Menarche on Symptoms, Cognition, Social Cognition, and Metacognition in Patients with First-Episode Psychosis

A protective effect has traditionally been attributed to estrogen in psychotic disorders. The aim of this study was to investigate cumulative lifetime estrogen by assessing the menstrual cycle length, age at menarche, and years of difference between the onset of psychotic symptoms and the age of menarche, measuring their effects on symptoms, cognition, social cognition, and metacognition. As it was not possible to directly measure cumulative estrogen levels over the lifetime of a patient, the study sample was composed of 42 women with first-episode psychosis; estrogen levels were inferred by the menstrual cycle length, age at menarche, and years of difference between the onset of psychotic symptoms and menarche. All patients were assessed with a battery of questionnaires using the BDI, PSYRATS, PANSS, STROOP, TAVEC, WSCT, IPSAQ, and BCIS questionnaires. The results related to menstrual cycle length showed a relationship with memory; specifically, shorter cycles with semantic strategies (p = 0.046) and longer cycles with serial strategies in the short term (p = 0.005) as well as in the long term (p = 0.031). The results also showed a relationship with perseverative errors (p = 0.035) and self-certainty (p = 0.049). Only personalized bias (p = 0.030) was found to be significant in relation to the age at menarche. When analyzing the differences in years of difference between the age at menarche and the onset of psychotic symptoms, the results indicated lower scores in women with a smaller difference between both events in memory (short-term (p = 0.050), long-term (p = 0.024), intrusions (p = 0.013), and recognition (p = 0.043)) and non-perseverative errors (p = 0.024). No relationship was found between symptoms and menstrual characteristics. The investigatory outcomes seem to indicate a relationship between estrogen cumulative effects and the memory domain. More in-depth investigations in the field are necessary in order to improve personalized treatment in women with psychosis.

FEATURES OF REPRODUCTIVE FUNCTION IN WOMEN WITH MISCARRIAGES

The aim of the study was to analyse the reproductive function of women with miscarriages among the population of Lviv region. The data of the results of medical and genetic counseling of 120 women with miscarriages who visited the medical and genetic center and the “Institute of Hereditary Pathology of the National Academy of Medical Sciences of Ukraine” were analyzed. The obtained indicators were compared with similar parameters of the control group: 80 healthy women who asked for family planning consultation. A group of women with miscarriage was formed to study the features of menstrual function, somatic, reproductive and gynecological history in comparison with similar indicators in healthy women. It was found that the majority of women (47 (39.2%) with miscarriages were aged 31–15 years and 74 (61.6%) of women by social status were employees. 52 (48.0%) women of the main group had the onset of menarche significantly later – after 15 years old, in 25 (20.8%) of them the duration of the menstrual cycle was 28–85 days and in 11 (9.1%) – 35–55 days (p &lt; 0.05). Women with miscarriages were significantly more likely to have a complicated somatic history and these are 86 (71.7%), mainly due to pathology of the cardiovascular system – 27 (22.5%), against 43 (53.75%) and 9 (11, 2%) (p &lt;0.05), respectively. All of them 120 (100.0%) had significantly more frequent complications of reproductive and gynecological history due to miscarriages and stillbirths. In the control group this figure was 11 (13.7%) and 19 (23.8%) respectively (p&lt;0.05).

Habitual Phytoestrogen Intake Is Associated with Breast Composition in Girls at 2 Years after Menarche Onset.

High phytoestrogen intake during adolescence is associated with a reduced risk of breast cancer. Breast density (BD) is a strong predictor of breast cancer and can be considered an early marker. We aim to assess the association between the mean habitual intake of isoflavones, lignans, and total phytoestrogens intake during puberty until 2 years after menarche onset and absolute fibroglandular volume (AFGV) and percentage of fibroglandular volume (%FGV) in Hispanic girls at the end of puberty. Longitudinal study set up in the Growth and Obesity Chilean Cohort Study (GOCS). We included 329 girls with dietary data (multiple 24-hours recalls) from puberty until 2 years after menarche onset (81% had 2-4 recalls). Two international datasets were used to estimate isoflavones, lignans, and total phytoestrogens in the diet. Breast composition was measured by dual energy X-ray absorptiometry at 2 years after menarche. Multiple linear regression models were used to assess the association between isoflavones, lignans, and total phytoestrogens intake and AFGV and %FGV. The average total phytoestrogen intake was 1 mg/day and %FGV was 50.7% (SD = 15.2) and AFGV 218.8 cm3 (SD = 79.3). An inverse association was found between consumption of isoflavones and AFGV, as well as, with total phytoestrogens [Q4 vs. Q1 adjusted model ß = -49.2 cm3; 95% CI (-85.5 to -13.0)]. Girls with a higher intake of total phytoestrogens and isoflavones during puberty until 2 years after menarche onset had significantly lower AFGV. Although the intake of phytoestrogens is low in Western populations, higher consumption of them during a critical period of life like puberty could be beneficial to reduce breast cancer during adulthood.

OHVIRA (Obstructed Hemivagina and Ipsilateral Renal Anomaly or Herlyn-Werner-Wunderlich syndrome): Is it time for age-specific management?

BackgroundOHVIRA (Obstructed Hemivagina and Ipsilateral Renal Anomaly or Herlyn-Werner-Wunderlich syndrome) is a rare Müllerian malformation. Usually, symptoms begin with worsening dysmenorrhea in post-menarche adolescents. The management in pre-menarche period is controversial and has only recently been subject of study. AimsTo review the experience of a pediatric tertiary center and to propose an age-specific management protocol for patients diagnosed before menarche. MethodsA retrospective cohort study (review of medical records - period 2009–2021). ResultsTwenty-eight patients were diagnosed (mean age 11.9 years), seven (25%) before menarche, one (3%) perinatally. One patient had Floating-Harbor syndrome. Twenty-three patients had ipsilateral renal agenesis, while five had a multicystic-dysplastic kidney. The contralateral kidney showed hypertrophy in 25 patients, pelvicalyceal ectasia in 8 and dysplasia in 1. Twenty-four patients were symptomatic. Three of the seven diagnosed prior to menarche had symptoms. All post-menarche diagnosed patients were symptomatic. Twenty-six patients underwent surgery (one-stage drainage, vaginal septal resection, and vaginoplasty). Asymptomatic pre-menarche patients were followed-up until surgery after menarche onset. No patient underwent surgery prior to menarche solely for OHVIRA diagnosis. At follow-up (median 3.5 years, 3 lost to follow-up), eighteen patients were asymptomatic, one developed endometriosis, one had impaired renal function, two needed reoperations. ConclusionsPre-menarche OHVIRA patients, without symptoms, should undergo regular follow-up until the onset of menarche. Surgery must be considered in post-menarche or symptomatic patients. Post-operative, long-term follow-up is required, evaluating both renal and gynecological issues. Level-of-EvidenceIV.

IDF21-0424 Age at Menarche, Type 2 Diabetes, Stroke and Chronic Inflammation among Individuals with Diabetes: NHANES 1999-2018

Background: Diabetes and diabetes complications are on the rise in U.S. adults aged under 65 years, while younger onset of menarche is also increasing. Therefore, it is critical to determine earlier life risk factors for diabetes and its complications such as stroke and to explore potential pathways involved in the progression of the disease. Aim: We examined the associations of menarche age with type 2 diabetes among women aged under 65 years and with stroke and chronic inflammation, assessed using C-reactive protein (CRP), among those women with diabetes. Method: Using the cross-sectional National Health and Nutrition Examination Survey (NHANES) 1999-2018, women aged 20-65 years free of cancer were included in the current analysis. Results: Of 17,377 participants, 1,773 (10.2%) reported having type 2 diabetes. Earlier age at menarche was associated with type 2 diabetes, compared to median menarche age 13 years, after multiple adjustment (p for linear trend <0.0001; Table). The association of earlier age at menarche was more pronounced with stroke among women with diabetes (p for linear trend ≤0.02; Table). In women with diabetes, younger age at menarche was associated with higher CRP levels (least square mean ± standard error: 5.6mg/L ±1.1 for age at menarche ≤10 years, 5.0±1.1 for 11 years, 3.3±1.1 for 12 years, 3.6±1.1 for 13 years, 3.3±1.1 for ≥14 years; p for linear trend 0.04). Discussion: Earlier age at menarche was associated with type 2 diabetes. Among women with diabetes, earlier age at menarche was associated with stroke complication and chronic inflammation among young and middle-aged women living with diabetes in the U.S.

Abstract P095: Associations Of Age At Menarche With Blood Pressures In Childhood And Adulthood

Objectives: The objective is to assess the associations of the timing of menarche with the blood pressures (BP) in childhood and adulthood. Methods: Participants of the Bogalusa Heart Study were included in this analysis (n=2,295). Our main outcome variables were systolic and diastolic BP in childhood and adulthood (≥20 years old). Incident hypertension was defined as systolic BP of 140 mm Hg or higher or a diastolic BP of 90 mm Hg or higher in adulthood (Stage 2). Age of menarche was defined as the reported onset of menstruation. Findings: Incidence of hypertension in adulthood was 3.1% (59/1929). Younger age at menarche was associated with high systolic and diastolic BP at both childhood and adulthood after multiple adjustments (all p for trend &lt;0.002; Table). Compared to individuals who had the onset of menarche at 12-13 years, earlier age at menarche (OR 1.65 [95% CI 0.91-2.99]) and later age at menarche (1.17 [0.56-2.42]) had a non-significant trend of higher odds ratios for stage 2 hypertension in adulthood. Conclusion: Younger age at menarche is associated with higher systolic and diastolic BP in both childhood and adulthood.

Onset of Menarche among Adolescent Girls in Gas and Non- Gas Flaring Environment in Bayelsa State, Nigeria

This research study investigated the onset of menarche among adolescent school girls living in non-gas and gas flaring environment in Bayelsa state. The participant in this study were eight hundred and twenty six (826) in number. The result obtained from the study shows that one hundred and fifty six (156) within the ages of 10-14years making (18.9%) are yet to attained menarche from gas flaring environment while (81.1%) have attained menarche in both environment. The overall age at menarche compared with body mass index was (12.6yrs) and (17.3kg/m²) from both group. Furthermore the age at menarche among adolescent residents in non-gas flaring environment was (11.8yrs) compared with those in gas flaring environment (12.9yrs). However the mean age at menarche among adolescent girls attending private schools was (12.7yrs) with a body mass index of (18.5kg/m²) in comparison with (12.5yrs) and (16.7kg/m²) of adolescent school girls attending public schools. The result from this study has shown that (50.8%) of school girls from gas flaring environment have attained menarche compared with (30.3%) from non-gas flaring environment at the age of (11.8yrs) with an increase positive percentage difference of (34.1%) between body mass index and the age at menarche among non-gas flaring adolescent and (37.2%), (22.9%) in gas flares stack surrounded communities in Bayelsa state.

Body mass index rebound and pubertal timing in girls with and without a family history of breast cancer: the LEGACY girls study.

Heavier body mass index (BMI) is the most established predictor of earlier age at puberty. However, it is unknown whether the timing of the childhood switch to heavier BMI (age at BMI rebound) also matters for puberty. In the LEGACY Girls Study (n = 1040), a longitudinal cohort enriched with girls with a family history of breast cancer, we collected paediatric growth chart data from 852 girls and assessed pubertal development every 6 months. Using constrained splines, we interpolated individual growth curves and then predicted BMI at ages 2, 4, 6, 8 and 9 years for 591 girls. We defined age at BMI rebound as the age at the lowest BMI between ages 2 and 8 years and assessed its association with onset of thelarche, pubarche and menarche using Weibull survival models. The median age at BMI rebound was 5.3 years (interquartile range: 3.6-6.7 years). A 1-year increase in age at BMI rebound was associated with delayed thelarche (HR = 0.90; 95% CI = 0.83-0.97) and menarche (HR = 0.86; 95% CI = 0.79-0.94). The magnitude of these associations remained after adjusting for weight between birth and 2 years, was stronger after adjusting for BMI at age 9, and was stronger in a subset of girls with clinically assessed breast development. Earlier BMI rebound is associated with earlier pubertal timing. Our observation that BMI rebound may be a driver of pubertal timing in girls with and without a family history of breast cancer provides insight into how growth and pubertal timing are associated with breast cancer risk.

A COMPARATIVE STUDY OF PREVALENCE OF ANEMIA AND ITS RISK FACTORS AMONG SCHOOL-GOING ADOLESCENT GIRLS IN THE FIELD PRACTICE AREAS OF MEDICAL COLLEGE IN GAUTAM BUDDHA NAGAR DISTRICT

Objectives: (1) The study was to determine the prevalence of iron deficiency anemia among adolescent girls in the field practice areas of a medical college of GautamBuddha Nagar district and (2) to assess the risk factors associated with iron deficiency anemia among adolescent girls in the field practice areas of a medical college of GautamBuddha Nagar district. Methods: A school-based cross-sectional study was conducted to assess the prevalence of anemia among adolescent girls of the field practice areas of the medical college of Gautam Buddha Nagar District. The sample size came out to be 236. One school each from RHTC and UHTC was selected randomly, and all adolescent girls were enrolled in the study. Results: The present study was conducted on 684 adolescent females (251 from RHTC and 433 from UHTC) in our study period of 3 months. The prevalence of anemia in the whole population was 42%, 54.5% among rural and 35.5% of adolescents in urban area were found to be anemic at the time of the study. The factors that were found to be significantly associated with adolescent anemia were age of onset of menarche, history of albendazole intake, residing in joint family, and lower socioeconomic status. Conclusion: The prevalence was high among girls who were above 16 years of age and girls who belonged to lower socio-economic groups and belonging to rural area. There is a need for a regular supply of iron and folic acid tablets and for improving medication adherence regarding consuming these tablets among adolescent girls and also about the dietary advice.

Overall Survival and Related Factors of Advanced-stage Epithelial Ovarian Cancer Patients Underwent Debulking Surgery in Jakarta, Indonesia: A Single-center Experience

AIM: The worrisome prognosis of advanced-stage epithelial ovarian cancer (EOC) needs a new perspective from developing countries. Thus, we attempted to study the 5-year overall survival (OS) of advanced-stage EOC patients who underwent debulking surgery in an Indonesian tertiary hospital. METHODS: A retrospective study recruited forty-eight subjects between 2013 and 2015. We conducted multiple logistic regression analyses to predict risk factors leading to unwanted disease outcomes. The OS was evaluated through the Kaplan–Meier curve and Log-rank test. Cox proportional hazards regression examined prognostic factors of patients. RESULTS: Prominent characteristics of our patients were middle age (mean: 51.9 ± 8.9 years), obese, with normal menarche onset, multiparous, not using contraception, premenopausal, with serous EOC, and FIGO stage IIIC. The subjects mainly underwent primary debulking surgery (66.8%), with 47.9% of all individuals acquiring optimal results, 77.1% of patients treated had the residual disease (RD), and 52.1% got adjuvant chemotherapy. The risk factor for serous EOC was menopause (odds ratio [OR] = 4.82). The predictors of suboptimal surgery were serous EOC (OR = 8.25) and FIGO stage IV (OR = 11.13). The different OS and median survival were observed exclusively in RD, making it an independent prognostic factor (hazard ratio = 3.50). 5-year A five year OS and median survival for patients with advanced-stage EOC who underwent debulking surgery was 37.5% and 32 months, respectively. Optimal versus suboptimal debulking surgery yielded OS 43.5% versus 32% and median survival of 39 versus 29 months. Both optimal and suboptimal debulking surgery followed with chemotherapy demonstrated an OS 40% lower than those not administered (46.2% and 20%, respectively). The highest 5-year OS was in serous EOC (50%). Meanwhile, the most extended median survival was with mucinous EOC (45 months). CONCLUSION: Chemotherapy following optimal and suboptimal debulking surgery has the best OS among approaches researched in this study. RD is a significant prognostic factor among advanced-stage EOC. Suboptimal surgery outcomes can be predicted by stage and histological subtype.

Associations Between Dietary Inflammatory Index and Sex Hormones Among 6- to 19-Year-Old Children and Adolescents in NHANES 2015-2016.

ObjectivesThis study aimed to assess the relationship between dietary inflammatory index (DII) and sex steroids in children (6-11 years old) and adolescents (12-19 years old) in the U.S. National Health and Nutrition Examination Survey, 2015–2016.MethodsParticipants between the ages of 6-19 have 24-hour dietary intake data, serum sex hormones [total testosterone (TT), estradiol (E2)], and sex hormone-binding globulin (SHBG) available data (n = 1382). The free androgen index (FAI) is calculated as TT divided by SHBG and the ratio of TT to E2 (TT/E2). The constructed puberty state is defined as high levels of steroid hormones (TT≥50 ng/dL in men, E2≥20 pg/ml in women) or onset of menarche. Multiple linear regression analysis was stratified by gender-age and gender-pubertal status groups to evaluate the association between DII and sex hormone levels.ResultsAfter adjusting for covariates, the association between consecutive DII and sex hormone indicators by gender and age group. In male adolescents, DII was always negatively associated with TT (P-trend = 0.09), FAI (P-trend = 0.03) and E2 (P-trend = 0.01), and monotonically positively associated with SHBG (P-trend = 0.02).In female adolescents, with the increase of DII, a significant positive correlation with SHBG was observed (β 0.017, 95%CI: 0.009,0.053) (Table 3). Among female adolescents, a significant negative association between DII and TT and a significant positive association between SHBG were observed in this group. Moreover, DII was positively associated with SHBG of prepubertal males and negatively associated with FAI of prepubertal females.ConclusionsDII was associated with decreased levels of certain sex steroid hormones (TT, FAI, and E2) and increased levels of SHBG in adolescents or pubertal individuals, with the associations presenting somewhat sex-dependent pattern. However, there is little evidence that there is a significant association in children or prepubertal children. Further research needs to be carried out to verify our results.

Mullerian Choristoma as a Cause of Tethered Cord Syndrome: A Case Report in a 13-Year-Old Worsening after the Onset of Menarche

Mullerian Choristoma as a Cause of Tethered Cord Syndrome: A Case Report in a 13-Year-Old Worsening after the Onset of Menarche