engleski

Age at menarche in Zagreb, Croatia, from 1964 to 2010 ; downward secular trend reflects nutritional status and socioeconomic changes

The onset of menstruation, which is a crucial step in female reproductive maturation, is influenced by both genetic and environmental factors. From 19th century on, a trend of decrease in mean age at menarche (AAM) has been detected in many industrialized countries, and one of the postulated prime factors contributing to earlier menarche are the increasing rates of childhood obesity. In this study we analyzed the secular trend of menarche in adolescents in correspondence to their weight and body mass index (BMI) through a 46- year-period (1964-2010). Sample consisted of 15-19-year-olds from six surveys conducted in Zagreb, Croatia: in 1964, 1973, 1982, 1990/91, 1997 and in 2010. Weight and BMI values were converted to Zscores and percentiles based on CDC references. In addition, the correlation of secular trend in menarche and body size parameters was examined in relation with real Gross Domestic Product (GDP). Both weight and BMI associated (≥85th and >95th percentiles) got their menarche earlier than their peers whose body size parameters indicated malnourishment (<5th percentile) or normal nutritional status (5th-85th percentile). Throughout the whole 46-year- period, the secular trend in AAM inversely correlated with mean BMI values (and weight), and all the three investigated variables mirror positive economic trends interrupted by the Croatian War of Independence (1991-1995). National GDP, which showed to be a sensitive marker of socioeconomic conditions, positively correlated with weight and BMI trends, and negatively with trends in AAM in the adolescents. Impact of the War left its visible traces on both the short- term effects (later AAM, decrease in weight and BMI of children at the beginning of the growth spurt) and long-term effects (earlier menarche, increased weight and BMI in children born during the War).

Body Mass Index; secular trend; age-at-menarche; adolescents; Gross Domestic Product; Zagreb

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