Association of Obesity in pubertal growth and early menarche among school going female children in Madurai district-A Cross sectional study.

BACKGROUND :

Obesity is a major public health problem that has grown to epidemic proportions throughout the world. Rates in adults range from 10 to 25% in most Western European countries and from 20 to 25% in some parts of the United States. In children and adolescents, the National Health and Nutrition Examination Survey (NHANES III) reported an estimated 20% prevalence of obesity, defined as a body mass index (BMI) greater than 85th percentile. For all age groups and degrees of obesity ,girls are higher risk than boys.

Obesity is not restricted to a single ethic, age, or socioeconomic group, although cultural, environmental, and genetic factors clearly play a role. The environmental factors that contribute to the development of a high degree of body fatness early in life include a high proportion of sedentary activities (eg, TV viewing), low proportion of physical activity, and a shift in diet towards more fast foods with high fat and calorie content. Among the genetic factors, polymorphism or mutations in any of the following genes may be involved in the pathophysiology of obesity

Leptin is a protein product of the obesity (ob) gene. It is secreted as a hormone mainly from white adipose tissue and serves as a signal for the brain of the body’s energy stores .By reducing food intake and increasing thermogenesis, leptin controls body fat tissue and, hence, body weight. Studies of its physiologic action in humans have shown a strong positive correlation between serum leptin concentrations and the percentage of body fat. Severe obesity is associated with a higher likelihood of continued overweight. This risk is much higher in children with obese parents. Studies have shown that parental obesity is the most important risk factor of obesity in children, owing to both the genetic influence and the shared environment (lifestyle, nutritional habits, food preferences, etc).

Several critical periods in childhood have been identified in the development and persistence of obesity. In the gestational period, there is a direct association of high birth weight with subsequent adiposity. Thereafter, in the first year of life, children undergo changes in nutritional behavior which may influence adiposity in later life. Another crucial period is ages of 5-8 years, where adiposity increases after its nadir in childhood (‘adiposity rebound’). An early adiposity rebound may serve an index of further obesity. The final risk period for the development of persistent obesity is adolescence.

The observation that overweight girls tend to mature earlier than lean girls has led to the hypothesis that the degree of body fatness may trigger the neuroendocrine events that lead to the onset of menses .obesity, as measured by BMI, A correlation was also found between age at adiposity rebound and age at menarche, As obese children have higher leptin levels than lean children, this may be an important factor in their earlier onset of puberty

OBJECTIVE :

To determine the association of obesity in pubertal growth and early menarche among school going female children in Madurai district.

STUDY DESIGN:

This is an Cross Sectional Study of Randomized Sampling method will be held for 6 months on Association of obesity in pubertal growth and early menarche among school going female children in Madurai district with 184 participants and her parent and to whom a questionnaire regarding the study and obtaining proper consent form, assent  form from the parent. participants who have Presence of any associated severe systematic illness ,Presence of pelvic pathology such as chronic pelvic infection, pelvic endometriosis, Actively taken any medications for other health problems  will be excluded from the study.

OUTCOME:

The Relation between the association of obesity in pubertal growth and early menarche among school going children in Madurai District will be reported.

RESULTS AND DISCUSSION:

The results will be statistically analysed and reported.

KEYWORDS:

Obesity, Early Menarche.