MS Onset in Childhood, Obesity, and Menarche

First, the endocrinologists speak:

J Pediatr Endocrinol Metab. 2012;25(1-2):57-62. Association of early menarche age and overweight/obesity.

Bralić I, Tahirović H, Matanić D, Vrdoljak O, Stojanović-Spehar S, Kovacić V, Blazeković-Milaković S.

Abstract

AIM: The aim of the study is to assess the association of overweight/obesity and early menarcheal age.

PATIENTS AND METHODS: The study comprised 2127 healthy girls aged 9 to 16 years. Menarcheal age was estimated by status quo method. The girls' body weight and height were measured and their body mass index (BMI) calculated. The diagnostic criteria of the WHO were used to define overweight and obesity. Girls with a BMI in the range of 1-2 for age and sex were considered overweight. Girls with a BMI >2 standard deviation (SD) for age and sex were considered obese. Girls with a BMI >1 SD for age and sex were considered overweight/obese. Social and economic status was analyzed according to years of education completed, parents' occupations, and the number of children in the family.

RESULTS: Median menarcheal age was 12.83 years; 25% girls had menarche before 11.98 years and 75% by 13.69 years. By 11.21 years, 10% of girls had had menarche, and 95% by 14.91 years. Girls who had menarche before 11.98 years had higher body weight values (48.5 vs. 40.2 kg) (p<0.001), height (159.3 vs. 149.2 cm) (p<0.001), and BMI (18.9 vs. 17.8 kg/m2) (p=0.003) than their peers without menarche. Girls with menarche before 11.98 years had significantly higher BMI values than girls with menarche after 13.69 years (18.94 vs. 17.84 kg/m2) (p=0.008). Girls with menarche before 11.98 years and those after 13.69 years differ significantly in distribution of thinness (3.4% vs. 2.54%), normal weight (85.3% vs. 91.8%), and overweight/obesity (11.2% vs. 5.7%) (p=0.002).

CONCLUSIONS: Girls who experienced early menarche are significantly more often overweight/obese. Overweight/obesity may be considered as one of the predictors for the early occurrence of menarche.

Now, the neurologists speak:

Neurology February 5, 2013 80:548-552; published ahead of print January 30, 2013,

Childhood obesity and risk of pediatric multiple sclerosis and clinically isolated syndrome

Annette Langer-Gould, MD, PhD, Sonu M. Brara, MD, Brandon E. Beaber, MD and Corinna Koebnick, PhD

ABSTRACT

Objective: To determine whether childhood obesity is a risk factor for developing pediatric multiple sclerosis (MS) or clinically isolated syndrome (CIS).

Methods: Cases were identified through the Kaiser Permanente Southern California (KPSC) Pediatric Acquired Demyelinating Diseases Cohort between 2004 and 2010. For cases, body mass index (BMI) was obtained prior to symptom onset, for the underlying cohort BMI was obtained through the KPSC Children's health study (n = 913,097). Weight classes of normal weight, overweight, moderate obesity, and extreme obesity were assigned based on BMI specific for age and sex.

Results: We identified 75 newly diagnosed pediatric cases of MS or CIS, the majority of which were in girls (n = 41, 55%), age 11–18 (n = 54, 72%). Obesity was associated with a significantly increased risk of MS/CIS in girls (p = 0.005 for trend) but not in boys (p = 0.93). The adjusted odds ratio and 95% confidence intervals for CIS/MS among girls was 1.58 (0.71–3.50) for overweight compared to normal weight (reference category), 1.78 (0.70–4.49) for moderately obese, and 3.76 (1.54–9.16) for extremely obese. Moderately and extremely obese cases were more likely to present with transverse myelitis compared with normal/overweight children (p = 0.003).

Conclusion: Our findings suggest the childhood obesity epidemic is likely to lead to increased morbidity from MS/CIS, particularly in adolescent girls.

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Hmm. An approximately twofold increase in early menarche, and an approximately twofold increase in risk of MS prior to adulthood. Roughly the same increases, seen with our spiking American childhood obesity. Shall we let the two specialties work this out together? I suppose so.

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