Sanja Blažeković-Milaković

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.

Late life depression: Challenge or curse for the general practitioner (GP). A cohort study

The aim of this study was to examine specificity of GPs care for elderly depressed patients. Among 17,000 examinees (10 GP-Offices) were extracted 231 patients with diagnosis of depressive episode (F32) and 152 with diagnosis of recurrent depressive disorder (F33) classified according to ICD-10. Older than 65 years were 134 depressed patients. Data were tracked longitudinally and obtained retrospectively for a 1-year period from 1st January to 31st December 2008. Questionnaire was designed for this study to estimate the care delivered to depressed patients. Logistic regression analysis showed that GP more often diagnosed depression in older patients, provided medical care for them and changed their therapy. The main therapy for up to 80% of elderly with diagnosis of recurrent depressive disorder was combination of pharmacotherapy and GPs support and psychiatrist psychotherapy, while more than 20% of elderly with diagnosis of depressive episode took only pharmacotherapy. In comparison with younger age group, elderly less frequently received psychotherapy and GPs support. GP has an important role in older depressed patient care, so improvement efforts could focus on GPs clinical skills of depression treatment, as well as therapy effectiveness and depression outcome for understanding treatment specificity within elderly.