Irena Bralić

Association of early menarche age and overweight/obesity

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.

P156 Paediatricians: responsible for the screening programme for developmental dysplasia of the hip (DDH)

Background and aims Developmental dysplasia of the hip (DDH) is the most common deformation of the loco-motor system, caused by multiple factors, which meets the criteria to be included in national screening.The aim of this study was to present arguments why paediatricians should be responsible for the DDH screening programme, on the basis of our own twenty-years of experience in conducting non-selective, combined clinical and ultrasound DDH screening, and a critical analysis of the available literature. Methods At their first regular check-up by a paediatrician at the age of 5 weeks, a total of 2720 infants with 5440 hips were examined clinically and by ultrasound. The clinical examination included the Barlow and Ortolani tests.The Graf method was used for the ultrasound examination. Results 89.4% of the infants had normal findings by ultrasound and 92.3% of the infants examined clinically. Three had a positive Ortolani test result, and one for Barlow: type II a + in 7.8%, type IIA- hips in 1.2%, type IIC in 0.9%, type IIIA in 0.5%, and type IV in 0.2% of the infants. 72% of the pathological hips shown by ultrasound were not recognised clinically. 9% of the population covered by the tests were referred to a paediatric orthopaedist for further observation. 2.8% of the population underwent conservative orthopaedic therapy, and none of the children were treated surgically. Conclusions Paediatricians responsible for non-selective combined clinical and ultrasound screening of the hips using the Graf method, are able to discover all forms of DDH at the age of 4 to 5 weeks, and provide orthopaedic therapy that is rational, accessible and practical for the parents and their child. Despite the sensitisation of paediatricians to the problem of early diagnosis of DDH, clinical examination as a screening method is subjective and insufficient due to its low sensitivity and the large proportion of false negative findings. Well-structured training, provided by licensed, professionally authorised educators, with the possibility of continual renewal of knowledge, is vital for optimal screening for DDH. The consistent application of diagnostic methods according to Graf, contributes to the objectivity, repeatability, feasibility and economically viability of DDH screening.