Article
Sickle cell disease and age at menarche in Jamaican girls:
observations from a cohort study
G R Serjeant, A Singhal, I R Hambleton
Medical Research
Council Laboratories (Jamaica), University of the West Indies,
Kingston, Jamaica
Correspondence to: Prof. G R Serjeant, Sickle Cell Trust, 14 Milverton Crescent, Kingston 6, Jamaica grserjeant{at}cwjamaica.com
Accepted 11 June 2001
AIMS
(1) To investigate the
distribution of age at menarche in a representative sample of 99 patients with homozygous sickle cell (SS) disease, 69 with sickle cell
haemoglobin C (SC) disease, and 100 controls with a normal haemoglobin
(AA) genotype followed in a cohort study from birth. (2) To explore the
determinants of the age at menarche.
METHODSChildren ascertained in a
newborn screening programme were followed prospectively from birth to
age 18-26.5 years with regular assessments of height, weight, pubertal
stage, and haematological indices at the Sickle Cell Clinic of the
University Hospital of the West Indies.
RESULTSAll subjects have now
reached menarche and the mean age in normal controls (13.0 years) was
significantly earlier than in SC disease (13.5 years) or SS disease
(15.4 years). Greater weight and earlier age at menarche was the only
association significant across all genotypes although additional
contributions occurred from fetal haemoglobin and red cell count in SS
disease. Alpha thalassaemia, which ameliorates many of the effects of
SS disease, had no discernible effect on menarche.
CONCLUSIONSMean age at menarche is
delayed by 0.5 years in SC disease and by 2.4 years in SS disease.
Weight appears to be the principle determinant of age at menarche.
Keywords: growth; menarche; sickle cell disease; body weight
© 2001 by Archives of Disease in Childhood
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