|Year : 2017 | Volume
| Issue : 2 | Page : 90-92
Age at menarche and its association with overweight/obesity among adolescents in Kano
Ibrahim Garba, Ayyuba Rabiu MBBS (BUK) , Idris S Abubakar
Department of Obsterics and Gynaecology, Bayero University Kano/Aminu Kano Teaching Hospital, Nigeria
|Date of Web Publication||15-Nov-2017|
Department of Obsterics and Gynaecology, Bayero University Kano/Aminu Kano Teaching Hospital, P.M.B. 3011
Source of Support: None, Conflict of Interest: None
Background: There was a dramatic decline of adolescents’ menarcheal age worldwide; Africa is witnessing a secular trend of this reducing menarcheal age among its black adolescents. A transition of overweight/obesity among adolescent is believed to be associated with reduced menarcheal age.
Materials and Methods: It was a descriptive cross-sectional study that was conducted among female adolescent girls from January to December, 2016. Ethical approval was obtained from the management concerned. All consenting adolescents were recruited for the survey. Information was recorded on a structured, pretested questionnaire. Their respective weight and height were also measured. Body mass index (BMI) was calculated using the formula: BMI = weight (kg)/height (m2). The data obtained were analyzed using the Statistical Package for the Social Sciences version 18.0 (SPSS Inc., SPSS Statistics for Windows, Chicago, IL, USA). Fishers’ exact test was used, and the P ≤ 0.05 was considered statistically significant.
Results: Two hundred and nineteen female adolescents participated in the survey. The mean age ± SD at menarche was 12.83 ± 1.312 years. The median and modal ages were both 13 years. There was no statistically significant association between the mean age at menarche and the ethnic groups (P(Fishers’) = 0.150). However, mean age at menarche was statistically associated with their BMI (P(Fishers’) = 0.00). Obesity was associated with reduced menarcheal age.
Conclusion: The median and mean ages at menarche were 13.0 and 12.8 years respectively, which were in accordance with secular trend of reduced menarcheal age among black adolescents. Our study also showed an inverse association between the age at menarche and overweight or obesity among adolescents.
Keywords: Adolescents, age at menarche, kano, obesity/overweight
|How to cite this article:|
Garba I, Rabiu A, Abubakar IS. Age at menarche and its association with overweight/obesity among adolescents in Kano. J Med Trop 2017;19:90-2
| Introduction|| |
Menarche is defined as the first occurrence of menstruation in a female. It signals the official onset of puberty in human females. The age at menarche has been dramatically declining among adolescents worldwide. In Africa, a secular trend of declining menarcheal age was observed among black adolescents. The worldwide median age at menarche is often difficult to estimate with high degree of certainty. It varies significantly by geographical location, ethnicity, socio-economic status, and several other factors., The global figure agreed of median age at menarche is 14 years with a range of 11–18 years.
Several workers,, have shown an inverse relationship between the age at menarche and obesity or overweight. Al-Awadhi et al. showed that there is an inverse association between age at menarche and obesity or overweight. Adesina et al. uncovered that reduced menarcheal age among adolescents in Port Harcourt was associated with obesity, overweight and stunting. A study conducted by Lin-Su et al. found that the mean age at menarche was higher among adolescents with normal weight than the obese and the overweight.
Convincing evidence has emerged that there is an ongoing transition of overweight/obesity among school aged children in Sub-Saharan Africa especially in urban living and adolescents of higher socio-economic status.
Kano, a city in the North-Western region of Nigeria, with a significant number of adolescents of background higher socio-economic status is assumed to be not left behind with this changing trend of early age at menarche and childhood transition of overweight/obesity.
This study was, therefore, aimed at determining and comparing the age at menarche of adolescent school girls in three secondary schools at Kano with different socio-economic settings and its association with the changing trends of overweight/obesity.
| Materials and methods|| |
It was a descriptive cross-sectional study that was conducted among female adolescent girls in three secondary school (GGSS Shekara, GGSS Dala, and St Louis SS, Kano) at Kano, North Western Nigeria. Ethical approval was obtained from Aminu Kano Teaching Hospital Ethical Committee and Kano State Ministry of Health. Consent/assent was obtained from the participants/guardians. All consenting adolescents were recruited for the survey. Information was recorded on a structured pretested questionnaire over the period of 1 year (from 1st January to 31st December, 2016). Data obtained on the respondents’ bio-data, age at menarche, and socio-demographic characteristics were recorded. Their respective weight and height were also measured using Camry Uliflex weighing scale (which was corrected to zero) and measuring tape respectively. Here, the adolescents were ensured that their pockets were empty while in school uniform and barefooted. Body mass index (BMI) was calculated using the formula: BMI = weight (kg)/height (m2).
The data obtained were analyzed using the Statistical Package for the Social Sciences version 18.0 (SPSS Inc., SPSS Statistics for Windows, Chicago, IL, USA). Fishers’ exact test was used and the P ≤ 0.05 was considered statistically significant.
| Results|| |
The survey was conducted in three girl’s secondary school from January to December, 2016. Two hundred and nineteen female adolescents participated in the survey.
The mean age ± SD at menarche was 12.83 ± 1.312 years. The median and modal age were both 13 years.
Hausa/Fulani was the major tribe 192 (87.7%) among the respondents followed by Igbos 14 (6.4%). A significant number of the adolescents 182 (83.1%) were of the Islamic faith; Christianity constituted 37 (16.9%) [Table 1].
There was no statistically significant association between the mean age at menarche and the ethnic groups (P(Fishers’) = 0.150). However, mean age at menarche was statistically associated with their BMI (P(Fishers’) = 0.00). There was a linear relationship of reduced mean age at menarche from overweight to underweight. Obesity was also associated with reduced menarcheal age [Table 2].
|Table 2: Cross-tabulation of median age at menarche with ethnic group and body mass index (BMI)|
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| Discussion|| |
The median age at menarche in this study was 13 years, which is lower than the global figure of 14 years. This also agreed with global decline in menarcheal age among adolescents and the observed secular trend of menarcheal age among black adolescents. In this study, the mean age ± SD at menarche was 12.83 ± 1.312 years. Adefuye et al. found a mean age ± SD at menarche of 13.8 ± 1.3 years among adolescents in South Western Nigeria. Uche and Okorafor also reported a mean age ± SD of 13.54 ± 0.07 years among secondary school girls in Enugu, South Eastern Nigeria. The figure, we found is lower than their findings. The declining age at menarcheal age and the level of their socio-economic status might have contributed to the difference.
We did not find a significant difference between the mean age at menarche and the ethnic groups. This is contrary to the findings of Adadevoh et al. in Ghana, where certain ethnic groups showed a statistically significant difference of menarcheal age. Smaller sample size and dominant Hausa/Fulani ethnicity in this study might have contributed.
We also found the mean age at menarche to be statistically associated with BMI. Here, there was reduced menarcheal age among adolescents who were overweight or obese when compared with those of normal BMI or underweight. The difference was statistically significant. Though, the BMI was not taken at the exact time the menarche was attained, the adolescents were presumed to be of higher BMI at their attainment of menarche when compared with their mate of underweight or normal BMI. Bralić et al. reported that girls who experienced early menarche are significantly more often overweight or obese. Al-Awadhi et al. reported similar findings.
| Conclusion|| |
The median and mean ages at menarche were 13.0 and 12.8 years, respectively, which were in accordance with secular trend of reduced menarcheal age among black adolescents. Our study also showed an inverse association between the age at menarche and overweight or obesity among adolescents.
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Conflicts of interest
There are no conflicts of interest.
| References|| |
Harris MA, Prior JC, Koehoom M. Age at menarche in the Canadian population: Secular trends and relationship to adulthood BMI. J Adolesc Health 2008;43:548-54.
James LL, Griffiths PL, Norris SA, Pettifor JM, Cameron N. Age at menarche and the evidence for a positive secular trend in urban South Africa. Am J Hum Biol 2009;21:130-2.
Boldsen JL, Mascie-Taylor CG. Geographical variation in age at Menarche in Britain. Int J Anthropol 1992;7:1-6.
Deb R. Variation in the age at menarche of the Assamese and Bengali girls of Guwahati, Assam. Anthropologist 2009;11:259-64.
Elshiekh M, Mohammed A. Influence of socio-economic status in the age at menarche and duration of menstrual bleeding. Mater Sociomed 2011;23:195-9. doi: 10.5455/msm.2011.23. 195-9.
Morris DH, Jones ME, Schoemaker MJ, Ashworth A, Swerdlow AJ. Familial concordance for age at menarche: Analysis from the breakthrough generations study. Paediatr Perinat Epidemiol 2011;25:306-11.
Thomas F, Renard F, Benefice E, De Meeus T, Guegan J. International variability of age at menarche and menopause: Patterns and main determinants. Hum Biol 2001;73:271-90.
Gathani T, Ali R, Beral DV, Raina V, Ganesan TS, Mathew SB et al.
Risk factors for breast cancer in India. An INDOX case-control study. INDOX Cancer Research Network. Available from: www.indox.org.uk/node/34
. [Last accessed on 2015 May 09].
Al-Awadhi N, Al-Kandari N, Al-Hassan T, Almurjan D, Ali S, Al-Tajar A. Age at menarche and its relationship to body mass index among adolescent girls in Kuwait. BMC Public Health 2013;13:29.
Adesina AF, Peterside O. Age at menarche and body mass index (BMI) among adolescent secondary school girls in Port Harcourt, Nigeria. IOSR J Dent Med Sci 2013;3:41-6. Available from: www.iosrjournals.org
. [Last accessed on 2017 Feb 07].
Lin-Su K, Vogiatzi MG, New MI. Body mass index and age at menarche in an adolescent clinic population. Clin Paediatr 2002;41:501-7.
Muthuri SK, Francis CE, Wachira LJ, LeBlanc AG, Sampson M, Onywera VO et al.
Evidence of an overweight/obesity transition among school-aged children and youth in Sub-Saharan Africa: A systematic review. PLoS ONE 2014;9:e92846. doi: 10.1371/journal.pone.0092846
Adefuye PO, Odusoga OL, Adefuye BO, Akindele RA. Age at menarche and menstrual pattern in secondary school girls in Sagamu. Niger J Clin Pract 2010;13:109-13. [Full text]
Uche GO, Okorafor AE. The age of menarche in Nigerian urban school girls. Ann Hum Biol 1979;6:395-8.
Adadevoh SW, Agble TK, Hobbs C, Elkins TE. Menarcheal age in Ghanaian school girls. Int J Gynaecol Obstet 1989;30:63-8.
Bralić I, Tahirović H, Matanić D, Vrdoljak O, Stojanović-Spehar S, Kovacić V, Blažeković-Milaković S. Association of early menarche age and overweight/obesity. J Paediatr Endocrinol Metab 2012;25:57-62.
[Table 1], [Table 2]