Menarche in Pediatric Patients with Crohn’s Disease
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Background and Aims
The timing of menarche in Crohn’s disease (CD) is poorly described. Our objectives were to study age at menarche onset in CD, and factors associated with this.
We compared the age at menarche of 34 CD patients with that for 545 controls, using data in the National Health and Nutrition Examination Survey (NHANES).
Mean chronological age (CA) of CD patients (15.6 years) did not differ from that of the NHANES cohort (15.7 years; P = 0.91). The median CA at menarche (13.9 years) in CD was older than in the NHANES sample (12.0 years) (P < 0.00005). In CD patients, the cumulative incidence of menarche was 10 % at CA 12 years, 51 % at CA 14 years, and 100 % at CA 16 years. Sixty-eight percent reached menarche by bone age (BA) 13.5 years and 100 % by BA greater than 14.0 years. Menarche occurred earliest in South Asians, followed by East Asians, and then Caucasians (P = 0.02).
CA at menarche is delayed in CD compared with the NHANES cohort. BA at menarche in CD is similar to BA at menarche reported for healthy children. CA at menarche in CD differs by race. If menarche has not occurred by BA greater than 14.0 years, endocrinology referral should be considered.
KeywordsInflammatory bowel disease Puberty Menses Children Adolescents
Z score based on bone age
Body mass index
Z score based on chronological age
Inflammatory bowel disease
National Health and Nutrition Examination Survey
University of California, San Francisco
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