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This version published online on August 22, 2006
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2006-0953
A more recent version of this article appeared on November 1, 2006
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Submitted on May 4, 2006
Accepted on August 10, 2006

Opposing Influences of Prenatal and Postnatal Growth on the Timing of Menarche

Charmaine S Tam*, Francis de Zegher, Sarah P Garnett, Louise A Baur, and Christopher T Cowell

Institute of Diabetes and Endocrinology, The Children's Hospital at Westmead, Westmead, NSW, Australia; Department of Pediatrics, University of Leuven, 3000, Leuven, Belgium; Discipline of Paediatrics and Child Health, The Children's Hospital at Westmead Clinical School, University of Sydney, Westmead, NSW, Australia

* To whom correspondence should be addressed. E-mail: CharmaiT{at}chw.edu.au.

Context and Objective: Menarche is a milestone of reproductive development and its timing may be differentially influenced by the growth conditions before birth and by those between birth and puberty. The present study explores the relationships among menarcheal timing and markers of prenatal and mid-childhood growth in healthy Australian girls.

Setting, Design and Patients: A total of 156 girls aged 8 yr from a birth cohort of full-term babies had height, weight and waist circumference measured. One hundred and three girls had DXA performed and blood analyzed for insulin, leptin, IGF-1, estradiol and DHEAS levels. Girls were followed up at age 15 yr and their age of menarche was recorded.

Main outcome measures: Age of menarche; birth weight, birth length; height, weight, waist circumference, body composition by dual x-ray absorptiometry (DXA), plasma insulin, leptin, IGF-1, estradiol and DHEAS at age 8 yr.

Results: Girls with earlier menarche were light and long at birth, and had higher total and central adiposity, IGF-1 and estradiol levels in mid-childhood compared with those with later menarche. Age of menarche was best predicted by combining size at birth and BMI z score at age 8 yr (r2=0.12; P < 0.001).

Conclusion: The timing of menarche appears to be influenced in opposing directions by pre- and postnatal growth. Menarche was found to occur earlier in girls who were long light at birth and who had a higher fat mass and circulating IGF-1 in childhood. These findings may partly explain ethnic differences and secular trends in the age of menarche.
Key words: menarche • birth size






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