Age at menarche in schoolgirls with and without excess weight / Idade da menarca em escolares com e sem excesso de peso

OBJECTIVE: To evaluate the age at menarche of girls, with or without weight excess, attending private and public schools in a city in Southeastern Brazil. METHODS: This was a cross-sectional study comparing the age at menarche of 750 girls from private schools with 921 students from public schools, aged between 7 and 18 years. The menarche was reported by the status quo method and age at menarche was estimated by logarithmic transformation. The girls were grouped according to body mass index (BMI) cut-off points: (thin + normal) and (overweight + obesity). In order to ensure that they belonged to different strata, 328 parents of these schools answered a questionnaire to rate the student's socioeconomic level. RESULTS: Menarche was reported by 883 girls. Although they belonged to different classes (p < 0.001), there was no difference in the nutritional diagnosis (p = 0.104) between them. There was also no difference in age at menarche between the girls studying in private (12.1 years, 95% CI: 12.0-12.2) and public schools (12.2 years, 95% CI:12.1-12.3; p = 0.383). When evaluated by nutritional status, there was difference only in the age at menarche between girls from private schools with excess weight and without excess weight (11.6 and 12.3 years; p < 0.001). The girls with excess weight attending private schools also had earlier an menarche than those attending public schools (respectively, 11.6 and 12.1 years; p = 0.016). CONCLUSIONS: Although the students from private schools belonged to a higher socioeconomic status, there is currently no longer a large gap between them and girls from public schools regarding nutritional and socioeconomic factors that may influence the age at menarche. .

OBJETIVO: Avaliar a idade da menarca em meninas, com e sem excesso de peso, que frequentam escolas particulares e públicas de uma cidade do sudeste do Brasil. MÉTODOS: Estudo transversal que comparou a idade da menarca de 750 meninas de escolas particulares com 921 alunas de escolas públicas, com idades entre sete e 18 anos. A menarca foi relatada pelo método status quo e a idade da mesma estimada pelo logito. As meninas foram agrupadas pelos pontos de corte do IMC em (magreza + eutrofia) e (sobrepeso + obesidade). Com o intuito de certificar que elas pertenciam a classes diferentes, 328 pais responderam a um questionário para classificar o nível econômico dos alunos. RESULTADOS: A menarca foi referida por 883 meninas. Embora elas pertençam a classes econômicas distintas (p < 0,001), não houve diferença quanto ao diagnóstico nutricional (p = 0,104). Também não houve diferença na idade da menarca entre as que estudam em escolas particulares (12,1 anos; IC95%%: 12,0-12,2) e públicas (12,2 anos; IC95%%: 12,1-12,3); p = 0,383. Quando avaliadas pelo diagnóstico nutricional só houve diferença na idade da menarca das meninas com e sem excesso de peso de escolas particulares (11,6 e 12,3 anos; p < 0,001). As meninas com excesso de peso das escolas particulares também menstruaram mais cedo do que as das escolas públicas (respectivamente, 11,6 e 12,1 anos; p = 0,016). CONCLUSÕES: Embora as alunas das escolas particulares ainda pertençam a classes mais altas, atualmente, não existe mais um abismo nutricional e socioeconômico tão grande entre elas quanto a fatores que podem influenciar na idade da menarca. .

Tendência secular da idade da menarca avaliada em relação ao índice de massa corporal / Secular trends in age at menarche in relation to body mass index

OBJETIVO: Avaliar a tendência secular da menarca de acordo com o índice de massa corporal (IMC). SUJEITOS E MÉTODOS: Seiscentos e oitenta e cinco meninas (7-18 anos) avaliadas em 2001 foram comparadas a 750 avaliadas em 2010. Elas foram agrupadas pelo Z-escore do IMC em: (magreza + eutrofia) e (sobrepeso + obesidade). A menarca foi relatada pelo status quo e a idade, estimada pelo logito. Foram utilizados os testes Qui-quadrado, Mann-Whitney e a Regressão logística, com significância de 5%. RESULTADOS: A menarca adiantou 3,24 meses entre 2001 e 2010. Houve aumento da obesidade e diminuição de eutróficas. O evento antecipou 1,44 mês no grupo magreza + eutrofia e 5,76 meses no sobrepeso + obesidade. Não houve interação entre os efeitos determinados pelo período avaliado e diagnóstico nutricional. CONCLUSÕES: Embora tanto o período quanto o IMC tenham influenciado a menarca, não se pode atribuir essa antecipação só à mudança do perfil nutricional da amostra. Outros fatores não testados podem estar contribuindo também para isso.

OBJECTIVE: To evaluate the secular trend of menarche according to body mass index (BMI). SUBJECTS AND METHODS: Six hundred and eighty five girls (7-18 years) assessed in 2001 were compared with 750 evaluated in 2010. They were grouped by BMI Z-score: (thin + normal) and (overweight + obese). Menarche was reported by status quo and age at menarche estimated by a logit model. We used the Qui-square test, Mann-Whitney test, and Logistic Regression, at a 5% significance level. RESULTS: Menarche advanced 3.24 months. There was an increase in obesity, and a decrease of the prevalence of normal girls. Menarche was anticipated by 1.44 month in the thin + normal group and by 5.76 months in the overweight + obese group. There was no interaction between the effects determined by the evaluated period and nutritional diagnosis. CONCLUSIONS: Although both the period and BMI influence the menarche, one cannot attribute this advance only to changes in the nutritional profile of the sample. Other factors that were not tested may also contribute to this finding.

Análisis comparativo del crecimiento y la maduración sexual entre niñas de Santa Rosa (La Pampa) y La Plata (Buenos Aires), Argentina

El objetivo del trabajo fue analizar comparativamente el crecimiento en relación con la menarca entre niñas de dos poblaciones urbanas argentinas. Se realizó un estudio antropométrico transversal, descriptivo-comparativo en 2.474 escolares comprendidas entre 8,0 y 16,9 años procedentes de Santa Rosa (SR) y La Plata (LP). Se registraron presencia de menarca y las variables antropométricas peso corporal, estaturas total y sentado, perímetro braquial, pliegues subcutáneos tricipital y subescapular. Fueron calculados índices de masa corporal, subescapular/tricipital y áreas muscular y adiposa del brazo. El grupo de estudio fue dividido en 4 grupos según ciudad y presencia de menarca. La caracterización socio-ambiental establecida mediante encuesta estructurada indicó diferencias significativas entre ciudades para condición de tenencia, características constructivas y servicios de las viviendas, cobertura de salud, asistencia monetaria, nivel educativo y ocupación laboral de los progenitores marcando un mayor bienestar en las jóvenes de SR. La menarca a una edad promedio de 12,7 años fue más prevalente en SR (40,6%) que en LP (33,7%) (c2=12,9; p< 0,05) que en general permanecieron en la comparación post hoc por edad en los grupos madurativos pre-menarca y post-menarca. La presencia de un tamaño corporal reducido, a expensas de menor estatura total, área muscular y longitud de piernas en las jóvenes de LP, asociados a una menor prevalencia de menarca en esta ciudad, representaría el costo adaptativo a un ambiente de menor bienestar.

Argentina. The aim of this study was to analyze growth in relation to menarche in girls from two Argentinean urban populations. We performed a comparative-descriptive cross sectional study in 2474 schoolchildren between 8.0 and 16.9 years old from Santa Rosa (SR) and La Plata (LP) cities. We registered the presence of menarche and anthropometrics variables of body weight, total and sitting heights, arm circumference, triceps and subscapular skinfolds. Body mass index, subscapular / triceps index and muscle and fat arm areas were calculated. The study group was divided into 4 groups according to the city and menarche. The socio-environmental structured survey indicated significant differences between cities with these variables: tenure status, building materials and services, health care coverage, cash assistance, educational level and parents' occupation, therefore establishing a higher welfare in youngsters of SR. Menarche at a mean age of 12.7 years old was more prevalent in SR (40.6%) than in LP (33.7%) (c2=12.9; p.

Spawning season, recruitment and early life distribution of Anchoa tricolor (Spix and Agassiz, 1829) in a tropical bay in southeastern Brazil / Período de reprodução, recrutamento e distribuição de jovens de Anchoa tricolor (Spix and Agassiz, 1829) em uma baía tropical do sudeste do Brasil

The pattern of the use of the Sepetiba Bay, a semi-closed 450 km² area in southeastern Brazil, by Anchoa tricolor was investigated to assess spawning period, recruitment and to detect spatial-temporal patterns of this major fishery resource. Fishes were sampled by seine nets, from spring, 1998 to winter, 1999 and by beach seine, from spring, 1998 to winter, 2000. Reproductive season, measured in terms of GSI, gonad development and appearance of recruits, indicate that reproduction occurs from August to March, when they reach the best condition. Recruitment peaks in winter/spring at sandy beaches where they stay until late summer, moving toward deeper bay areas during autumn. After that, they join adults and perform movements between the bay and the adjacent continental shelf to reproduce.

O padrão de uso da Baía de Sepetiba, uma área semifechada no Sudeste do Brasil, por Anchoa tricolor foi estudado visando determinar o período reprodutivo, recrutamento e detectar padrões de distribuição espacial e temporal. As amostras foram realizadas por rede de cerco, entre a primavera de 1998 e o inverno de 1999, e por arrasto de praia, da primavera de 1998 ao inverno de 2000. O período reprodutivo, estimado com base no índice gonadossomático, desenvolvimento gonadal e aparecimento de recrutas, ocorre de agosto a março, quando é atingida a melhor condição dos adultos. O recrutamento ocorre principalmente no inverno/primavera nas praias arenosas onde eles permanecem até fins do verão, movendo-se para áreas mais fundas da baia durante o outono. Depois disto eles se juntam aos adultos e fazem movimentos entre a baia e a plataforma costeira adjacente para reproduzir.

Densidade mineral óssea de crianças e adolescentes com hipotireoidismo congênito / Bone mineral density of children and adolescents with congenital hypothyroidism

Realizou-se estudo transversal com 60 pacientes (9,9 ± 1,8 anos) com hipotireoidismo congênito (HC) (grupo A): 40 meninas (23 pré-púberes) e 20 meninos (18 pré-púberes), com grupo controle (grupo B) constituído por 28 indivíduos (10,4 ± 2,1 anos): 18 meninas (8 pré-púberes) e 10 meninos (9 pré-púberes). OBJETIVOS: Avaliar a densidade (DMO) e o conteúdo mineral ósseo (CMO) e correlacioná-los com idade cronológica e óssea (IO), sexo, maturação sexual, dose de l-T4, TSH, TT4, FT4, e etiologia do HC. IO, DMO e CMO de corpo total (DXA) foram obtidos dos 2 grupos; TSH, TT4 e FT4, apenas dos pacientes. DMO foi menor no grupo A (0,795 ± 0,075 g/cm² vs. 0,832 ± 0,092; p = 0,04) e maior nas meninas púberes do que nas pré-púberes (p = 0,004). Não houve diferença significativa de DMO e CMO quanto ao sexo e etiologia do HC. Nosso estudo mostra que a DMO foi significativamente menor no grupo com HC, diferente dos dados da literatura.

A cross sectional study was made on 60 patients (9.9 ± 1.8 yr-old) with congenital hypothyroidism (CH) (group A): 40 girls (23 prepubertal) and 20 boys (18 prepubertal). Control group (group B) was constituted of 28 healthy children (10.4 ± 2.1 yr-old): 18 girls (8 prepubertal) and 10 boys (9 prepubertal). AIMS: To evaluate bone mineral density (BMD) and content (BMC) and to correlate them with chronological and bone age (BA), sex, sexual maturation, l-T4 dose, TSH, TT4, FT4, and CH etiology. BA, total body BMD, and BMC (DXA) were obtained of both groups. TSH, TT4, and FT4 were measured in patients only. BMD was lower in group A (0.795 ± 0.075 g/cm² vs. 0.832 ± 0.092; p = 0.04) and higher in pubertal than in prepubertal girls (p = 0.004). There was no significant difference between BMD and BMC related to sex and CH etiology. Our data demonstrated that BMD was significantly lower in children with CH, different from what has been published in the literature.

Cronología del desarrollo puberal en niñas escolares de Santiago: relación con nivel socio-económico e índice de masa corporal / Age of pubertal events in Chilean school age girls and its relationship with socioeconomic status and body mass index

Background: Recent studies in the United States have demonstrated that a significant proportion of girls show thelarche before the age of eight years. Nutritional status, geographic influences and racial factors are known to affect the timing of puberty. Aim: To evaluate the age of onset of puberty, development of secondary sexual characteristics and menarche in Chilean girls, and its relation to obesity and socioeconomic status. Material and methods: Healthy girls attending elementary school, from first to ninth grade in Santiago, Chile, were studied. A pediatric endocrinologist evaluated pubertal development using Tanner classification. Breast development was assessed by inspection and breast palpation. Average age of onset of pubertal events was determined by probit analysis. Results: A total of 758 girls, aged 5.8 to 16.1 years, were recruited. Obesity, defined as a BMI greater than 90th percentile, was found in 24.4 percent. The age of menarche was 12.7 years, the onset of Tanner stage 2 breast development and pubic hair was at 8.9 and 10.4 years, respectively. Sixteen percent of girls aged 7 to 7,9 years, had thelarche. Upper class girls showed a later onset of breast Tanner stage 4 stage than low-middle class girls. Obesity was not found in logistic regression analysis to be a significant predictive factor in the onset of puberty. Conclusions: The age of menarche has not changed in the last thirty years, but an earlier onset of thelarche has occurred. The high frequency of thelarche between 7 and 8 years suggests that the normal age of breast development should be revised.

Evaluación clínica de niños diabéticos relacionada al estado de salud bucal / Clinical evaluation of diabetic children in relation to oral health status

La diabetes mellitus es una enfermedad crónica y sistémica que puede ocasionar complicaciones irreversibles. En este trabajo se presenta un análisis del estado clínico de niños diabéticos y su relación con los exámenes de laboratorio y de salud bucal que ellos presentaban en el momento del estudio. Se determinaron glucosa por el método enzimático específico, y hemoglobina glicosilada por el método cromatográfico, y los índices gingival y de placa bacteriana según Loe y Silness. Estos niños llevan un adecuado control metabólico por cuanto existe ausencia de lesiones microvasvulares. La diferencia entre edad ósea y edad cronológica se observa cuando la diabetes se asocia a tiroiditis. Además, estos niños prsentan elevado número de caries dental y alto riesgo de gingivitis, aspectos que estarían poco relacionados linealmente con la antiguedad de la enfermedad. El examen bioquímico de la saliva no reveló correlación estadística entre glucemia, hemoglobina glicolsilada y glucosa salival. Es fundamental insistir sobre medidas preventivas destinadas a mejorar el estado de salud bucal de los pacientes diabéticos

Desarrollo puberal y edad ósea en niños con antecedentes de desnutrición calórico-proteica grave precoz / Puberal development and bone age in children with early severe protein-energy malnutrition

La desnutrición grave y prolongada retrasa el crecimiento y desarrollo en el niño. Esto se ve objetivado en el menor tamaño corporal y el enlentecimiento dela maduración de diferentes tejidos, incluyendo el hueso. El retraso de la edad ósea alargaría el período de crecimiento recuperacional, si la situación nutricional mejorara. Se comparó, a una edad promedio de 12 años y 5 meses, el crecimiento estatural, la maduración ósea y el desarrollo puberal en 20 niños (10 niñas) que sufrieron desnutrición calórico-proteica grave precoz que requirió tratamiento hospitalario, con las de otros 20 niños de igual condición socioeconómica, edad y sexo, sin antecedentes de desnutrición. Se registraron diferencias significativas en el tamaño corporal en favor del grupo control (p<0,001) tanto entre los hombres como en las mujeres. Las edades óseas medidas en 18 niños de grupo de estudio (9 mujeres) y 17 controles (9 mujeres) mostraron un retraso leve, que no alcanzó significación, en todos los grupos. Las etapas puberales alcanzadas fueron semejantes en casos y controles para los dos sexos, independientemente del antecedente nutricional. Estos hallazgos sugieren que la desnutrición grave precoz, tratada, produce retraso en el crecimiento estatural pero no afectaría la maduración ósea y la maduración sexual