ISSN: 2329-8901
Research Article - (2017) Volume 5, Issue 1
Background: Menarche is defined as the first menstrual period. It is considered to be the most obvious sign of puberty in girls. It has been regarded in many cultures as a transitional step to womanhood. Nutrients are needed in varying amounts depending on one’s stage of growth.
Objectives: Compare Anthropometric variation of Pre-menarcheal and post-menarcheal girls, Effect of body fat on menarcheal status.
Study design: This study is done on adolescent counselling centre named anwesha clinic Anthrometric measurement are taken for this study.
Method: Subjects: Adolescent school girls aged 10-19 years of Salboni Block of Paschim Medinipur the study area of Salboni Block is 25 km away from Medinipur town. Subjects are 10-19 years adolescent girl, the study were done on 1009 girls. Age at menarche of each girl was obtained by ‘status-quo’ method; with this method it is possible to collect menarche data for large representative samples of girls within a comparatively short period.
Results: By comparison of Anthropometric variable it shows that post-menarcheal is higher anthropometric status. Mean difference in height, weight, MUAC, Triceps, Biceps, Fat Mass, Fat Free Mass, Body Mass Index, per cent body fat are 8.73, 3.69. 3.75, 1.56, 9.2.5.2, 4.99, 2.96, 2.41; they are significant comparison of pre-menache and post-menacheal anthropometric shows post-menarcheal girls’ anthropometric status is high. Higher per cent body fat girls experience early menarche
Conclusion: Delayed menarche may be a sign of malnutrition since as nutritional status improves; the attainment of menarche is lowered. Attainment of menarche decreases when BMI increases. There is a correlation between BMI and attainment of menarche and also, there is a correlation between early obesity and early onset of menarche. Girls with early onset of menarche had higher BMI than those with late onset of menarche.
Keywords: Adolescence; Menarche; Body mass index; Per cent body fat
Menarche is most important event of girls’ adolescence period, it is sign of fertility of a girl. Menarche initiated by initiation of hormone like estrogen, and growth occurs in uterus and endometrium, according tanner growth menarche occurs after thelarche, in this period adolescence growth spurt occurs, to complete growth adolescence need sufficient nutrition, which help adolescence to reach adult stage, not only nutrition genetic, geography which effect on growth and menarche, age at menarche differ with ethnicity, heredity, even family structure, socio-economic status,17% body fat is necessary to onset of menarche, some chronic disease, malnutrition cause behind delayed menarche, study shown that Indo-Iranian including Indian north American girls shown first bleeding around 12.5 44 days decreased in mean age at menarche by 5 year birth cohort which varies UK in 18 days and 58 days in Germany. At mid adolescence period growth rate increased and reach peak height velocity, adolescence reached highest pubertal height then hat stage there is no significant difference to the duration of pubertal growth irrespective of the timing of the onset of puberty Early menarche may happens due to single nucleotide polymorphism of LIN28B (Karapanou and Papadimitriou).
Due to lack of knowledge about nutrition supplement, adolescent suffers from malnutrition and experienced stunted growth which effects mean age at menarche, in rural area girls walk bare foot and go for open defecation, this cause worm infestation which cause anaemia and it delayed their menarche, early age marriage causes early conception before adolescent reach physically mature they give birth low weight child and they become under nutrient adolescent. After experiencing menarche, there will be some other changes that support reproductive function, such as breast growth. Median age at menarche still has decreased significantly, but with a slower pace of approximately about one month per decade to 13.05 years in 2009. Median menarcheal age in girls of Turkish (12.50 years) and Moroccan (12.60 years) descent was 3.6 months earlier in 2009 than in 1997, a decrease of approximately three months in a decade suggesting a secular trend. In the same period the difference in median age at menarche between Dutch girls and girls from Turkish and Moroccan descent has increased with 2.4 months to 6.6 months and 5.4 months, respectively. De has found that post menarcheal girls have higher body composition in compare to pre-menarcheal and mean age at menarche 11.88 years In this it shows that menarcheal girls have higher Anthropometry [1]. Bhadra et al. demonstrated that the post-menarcheal Bengali girls had significantly greater amount of total body fat mass than their pre- menarcheal counterparts. Anthropometry is tool to measure growth pattern in period of adolescence stage. Banik presents age at menarche and prevalence of undernutrition and poor health status appraised by Rohrer Index among girls (n=238) in Purulia district of West Bengal Joseph et al. in a study on adolescent girls in rural India, observed the mean age at menarche was to be 13.9 years and Nair et al. in study on unmarried females in rural area of Delhi, observed the mean age at menarche was to be at 13.6 years, which were almost similar to the mean age at menarche (13.19 years) of rural school girls. Acharya et al in study on adolescent girls in South Delhi, observed that the mean age at menarche was 13.34 (1.26) years, which was almost similar to the mean age at menarche in urban school girls 12.67 (1.4) years. Mean age at menarche is 12.19 years (1.03). Age 12 years early menarche slow down when increase in height shown in tapai city girls of Taiwan (suhuchan 2000) Sachen etal (2012) found mean age at menarche is 12.84 years in north Indian district school girls.
The study area of Salboni Block is 25 km away from Medinipur town. Subjects were 10-19 years adolescent girls. The study had been done on 1009 girls. For this study different types of anthropometric measurements were taken like Weight, Height. Height is measured through Anthropometric rod; Weight was taken by weighing machine. Biceps skinfolds and Triceps skinfolds measurements were taken by skinfold Calliper. Height was measured to the nearest 0.1 cm and weight to the nearest 0.5 kg. Each subject was weighed with minimum clothing and no footwear. Structured questionnaires were followed to know details of socio-economic status of studied adolescent. Stature was measured to the nearest 0.1 cm in bare feet with participants standing upright against a wall-mounted stadiometer. Body mass was measured to the nearest 0.5 kg with participants lightly dressed (using a portal digital scale (Tanita HD 309, Creative Health Products, MI USA). BMI was calculated from the ratio of body mass index.
Statistical analysis
Data were entered in Microsoft excel 2007 and was analysed using SPSS 19.0. Descriptive statistics and chi square test were used wherever required, to test statistical significance. Statistical significance was set at p<0
Results
In this study shows median age of menarche is 12 years and age range of menarche is 9-17 years, 34.2% experience menarche at age of 12 years. Tables 1 and 2 represent those girls who have higher BMI (kg/ sqm) experience menarche. Among study group 136 girls are under nutrient. Table 3 shows mean differences of different anthropometric variables.
Menarcheal Status | Nutritional Status | Total | ||||
---|---|---|---|---|---|---|
CEDIII | CEDII | CEDI | Normal | Overweight | ||
Pre-menarcheal status | 2 | 1 | 136 | 740 | 3 | 882 |
Post-menarcheal | 28 | 36 | 28 | 21 | 0 | 113 |
Total | 30 | 37 | 164 | 761 | 3 | 995 |
Table 1: Menarche and Nutritional Status of studied Adolescent girls.
Nutritional status | Mean | N | Std. Deviation |
---|---|---|---|
CEDIII | 1.9512 | 41 | .21808 |
CEDII | 1.9487 | 39 | .22346 |
CEDI | 1.1707 | 164 | .37743 |
Normal | 1.0276 | 761 | .16392 |
overweight | 1.0000 | 4 | 0.00000 |
Total | 1.1239 | 1009 | .32961 |
Table 2: Mean and SD of nutritional status of Adolescent girls.
Variable | Post-menarche | Pre-menarche | Mean difference | t value |
---|---|---|---|---|
weight(kg) | 45.64(4.18) | 36.90(4.14) | 8.73 | 21.86 |
Height(cm) | 151.48(4.64) | 147.79(4.76) | 3.69 | 8.29 |
MUAC(cm) | 22.17(2.52) | 18.42(2.89) | 3.75 | 15.92 |
Triceps Skinfold | 9.17(1.99) | 7.60(1.71) | 1.56 | 8.35 |
Biceps skinfold | 6.25(1.54) | 5.27(1.27) | 0.97 | 6.75 |
Fat Mass(kg) | 9.96(1.89) | 7.13(1.39) | 2.52 | 14.39 |
Fat Free mass(kg) | 34.84(4.11) | 29.84(3.36) | 4.99 | 12.96 |
Body Mass Index(kg/sq m) | 19.86(1.42) | 16.89(1.73) | 2.96 | 21.23 |
Percent body fat | 21.66(2.98) | 19.24(2.68) | 2.41 | 8.56 |
Table 3: Anthropometric and body composition characteristics of the subjects.
Among study group total 244 girls are under nutrient 41 grade III under nutrient, By comparison of a anthropometric variable, it shows that post-menarcheal are higher anthropometric variables in mean difference in height, weight, MUAC, Triceps, Biceps, Fat Mass, Fat Free Mass, Body Mass Index, Per cent body fat are 8.73, 3.69. 3.75.1.56, 0.97, 2.52, 4.99, 2.96, 2.41 respectively, they are significant in Tables 4 and 5. Since there were significant differences in overall adiposity.
Dependent | B | Beta | SEB | t | Adjusted R |
---|---|---|---|---|---|
Per cent Body Fat | 0.135 | 0.234 | 0.018 | 7.63 | 0.054 |
Fat Mass(kg) | 0.469 | 0.538 | 0.023 | 20.24 | 0.289 |
Fat Free Mass(kg) | 0.246 | 0.609 | 0.01 | 24.34 | 0.37 |
Fat Mass Index(kg/sqm) | 1.265 | 0.547 | 0.061 | 20.72 | 0.298 |
Table 4: Multivariate Regression Analysis of different Anthropometric measurement of studied girls.
Community | Per cent Body fat |
---|---|
Wang and Bachrach (USA) Asian | 2.8 |
Black | 6.8 |
Hispanic | 5.1 |
White | 0.6 |
Sampei et al. (Brazil) Japanese | 7.5 |
Caucasian | 5.5 |
Present study (India) Bengalee | 2.4 |
Table 5: Differences in mean PBF between MG and PMG girls in different ethnic groups Study Ethnic group Difference (%) in mean PBF between MG and PMG girls.
(BMI) between PMG and MG, multivariate regression analyses were undertaken which was tested for the effect of menarcheal status on PBF, FM, FFM, and FMI. Result denotes mean age at menarche had significant relation. It revealed that attainment of menarcheal status had significant impact on all four (PBF P<0.0001; FM: P<0.0001; FFM: P<0.0001; FMI: attainment of menarche has a significant (P<0.001) effect on all anthropometric characteristics except the two indices of central fat distribution (WHR and CI). Test of significant (t-test) demonstrated that attainment of menarche had a significant effect on height, weight, BMI, WC, HC.
Nutritional deficiency inadequate iron consumption can delayed menarche. BMI reflects only relative overweight, and not actual body fat mass. adiposity can be estimated by body fat and BMI and those It can be concluded that difference in mean PBF between Bengalee MG and PMG girls (7.7%) was most similar to the Jcan be evaluated by height, weight, skinfolds, different circumferences, apanes girls (7.5%) In Brazil, it is followed by African-Americans (6.8%) in the USA. In conclusion, these studies clearly indicate that, in general, there exist higher adiposity levels among MG girls compared with PMG girls. Several earlier studies have indicated that differences existed in body fat between pubertal females and those that have not reached puberty. The results presented in this research work provide further support. From the result, the mean BMI for pubertal females was 19.86 while that for prepubertal females was 16.89. The difference between these two means is very statistically significant (P<0.05). This research also gives a document that the difference between menarcheal females mean BMI as compared to the mean BMI of premenarcheal females was significant (P<0.05).In this study per cent body fat represents higher in post menarcher girls onset of menarche. Per cent body fat has positive correlation with mean age at menarche, it indicates per cent body fat which influences mean age at menarche. The median age at menarche for bania girls in present study was found to be 12.3 years. This is in close agreement with menarcheal ages as reported by earlier studies conducted on adolescent girls [2-7].
Delayed menarche may be a sign of malnutrition A.s nutritional status improves; the attainment of menarche is lowered. Attainment of menarche decreases when BMI increases. There is a correlation between BMI and attainment of menarche and also, there is a correlation between early obesity and early onset of menarche. Girls with early onset of menarche had higher BMI than those with late onset of menarche.
At first I thankfully acknowledge to authorities of the Department of Anthropology, Vidyasagar University for providing me indispensable amenities, I convey my deep sense gratitude and earnest thanks to my Supervisor Prof Kaushik Sankar Bose for his pleasant guidance and careful assistance I thankfully acknowledge to clients of Anwesha Clinic for open handed support and cooperation during field Survey. I also express my loving thankfulness to all adolescent girls who participated in research survey.
There are no conflicts of interest.
To complete this study verbal consent of subjects are taken, this study does not harm other.