ESPE2024 Poster Category 2 Fat, Metabolism and Obesity (39 abstracts)
Identification of menstrual disorders in Polish adolescent girls with severe obesity. Preliminary results of the Polish-German research project on early-onset severe obesity
Żaneta Malczyk 1 , Magdalena Mierzwa 2 , Mirosław Bik-Multanowski 3 , Stephanie Brandt 4 , Bertram Flehmig 5 , Ewa Małecka-Tendera 6 , Artur Mazur 7 , Elżbieta Petriczko 8 , Michael B Ranke 9 , Martin Wabitsch 4 , Małgorzata Wójcik 10 & Agnieszka Zachurzok 1
1Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Zabrze, Poland. 2Pediatric Endocrinology Ward, Independent Public Clinical Hospital No. 1, Medical University of Silesia in Katowice, Zabrze, Poland. 3Department of Medical Genetics, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland. 4Center for Rare Endocrine Diseases, Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, Ulm, Germany. 5Mediagnost GmbH, Reutlingen, Germany. 6Department of Pediatrics and Pediatric Endocrinology, Medical University of Silesia, School of Medicine in Katowice, Katowice, Poland. 7Department of Pediatrics, Pediatric Endocrinology and Diabetes, Medical Faculty, University of Rzeszów, Rzeszów, Poland. 8Department of Pediatrics, Endocrinology, Diabetology, Metabolic Disorders and Cardiology of Developmental Age, Pomeranian Medical University, Szczecin, Poland. 9Children’s Hospital, University of Tübingen, Tübingen, Germany. 10Department of Pediatric and Adolescent Endocrinology, Pediatric Institute, Jagiellonian University Medical College, Kraków, Poland
Background: Obesity is increasingly being diagnosed in the paediatric population. Obesity during childhood and adolescents is related to an increased risk for cardiovascular diseases, high blood pressure, diabetes mellitus and menstrual disorders including heavy menstrual bleeding, oligomenorrhea, dysmenorrhea.
The study aim: is to investigate the incidence of menstrual disorders in adolescents with severe obesity.
Methods: The study group included 145 patients with severe obesity with a BMI z-score 3.5±0.21, aged 12-17 years enrolled in the Polish-German Study Project on Severe Early-Onset Obesity (SEOO) in four Polish Medical Centers. Physical examination with anthropometric measurement and assessment of body mass composition was performed in all subjects. Patients completed the questionnaire about menarche, length and regularity of the menstrual cycle, menstrual bleeding and dysmenorrhea.. Patients rated their pain on a five-point scale.
Results: In the study group, the average age at menarche was 11 years (11.36±1.24 years). It was observed that 56 girls (37%) had irregular menstrual cycle. These patients had a statistically significantly larger waist circumference (115.57±13.77 vs. 110.49±12.25 cm; P = 0.023), longer menstrual cycle (45±35.3 vs. 30±8.2 days; P <0.001) and more frequent hirsutism (25% vs. 10%; P = 0.023) compared to girls with obesity who menstruate regularly. 48 patients (33.3%) reported heavy menstrual bleeding and 27 (18.9%) hypomenorrhea. 86.1% girls were suffering from dysmenorrhea. 21 patients did not report any menstrual disorders. A statistically significant correlation was observed between the intensity of menstrual bleeding and dysmenorrhea (Τ=0.22, P = 0.002) between dysmenorrhea and the severity of acne (Τ=0.16, P = 0.02). Age at menarche and was positively correlated with the age at onset of obesity (r =0.33, P = <0.001). There was no relationship between menarche age and body mass index. The menstrual cycle length was average 30±25.3 days and correlated positively with body weight (r =0.21, P = 0.01), BMI (r =0.20, P = 0.02), waist circumference (r =0.21, P = 0.01) and body fat percentage (r =0.17, P = 0.04). Menstrual bleeding lasted an average of 5 days and was negatively correlated with fat-free mass (r =-0.18, P = 0.03).
Conclusion: The results indicate that severe obesity is associated with more frequent than in general population of adolescents (86 vs. 75%) occurrence of menstrual disorders like earlier menarche, dysmenorrhea, hypomenorrhea or hypermenorrhea and menstrual cycle irregularity.
The study was financed by the National Science Centre (2021/41/B/NZ5/01676).
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