Cambios de menarquia y aproximación al riesgo cardiovascular en mujeres que asisten al Instituto de Endocrinología - Bogotá
Montoya Hurtado, Laura Cristina
Barrero Farfán, María
Summary: Menarche is an important event in the life of all women, demarcates culturally and physiologically the transition to a reproductive life, however may vary by biological factors, those initially given by the genetic factors, and subsequently by other factors such as body weight, nutrition and environmental factors; a sable socioeconomic stratum, climate, ethnicities, among others. Studies worldwide have determined an advance in the age of presentation: Norwegians, Finns and North Americans observed an advance menarche in 0.3 years for each decade22. In Colombia, there is only one study titled Trends and correlations of age in menarche in Colombia: results of a representative survey at the national level that examines the trend and correlates sociodemographic analysis of the age of menarche of Colombian girls. Where I know concluded that it had a decrease of approximately 0.54 years / decade (P <0.001); However, only 1 decade (1992-2000) was used for the comparison, and they were all teenagers11. It is also known that the woman with the The greatest risk in life and especially after 45 years suffer cardiovascular diseases and in some studies it has been achieved that The early presentation of menarche has a part of these risk factors. A British study, from the University of Cambridge, shows that women who have menarche before age 12 present greater risk throughout their life of experiencing a myocardial infarction or cerebral ischemic event. : Further have a higher risk of death of 22% for all causes, of 28% in cardiovascular disease and 25% of cancer 20, 21. Objective: To establish the variation in the age of menarche in the last 60 years and explore the cardiovascular risk associated with menarche in older women 45 years. Methodology Exploratory cross-sectional study with analytical component of patients who attend the Endocare Endocrinology Institute in Bogotá, will include women born in Colombia between 1947 and 2010, grouping them for decades and selecting according to the sample in a random way. They were extracted of the clinical history the age of the menarche and search of the proposed variables to meet the objectives. The information was exported to the statistical software Stata V12 ® where the statistical analyzes were performed. Results: In the group of patients studied a difference was evidenced significant in the age of menarche according to the decade of birth, evidencing a lower age in the most recent decades. With the passage of decade the age of menarche has been reduced by 0.47 times the age of women. The age of the presentation of menarche in decades 1940 and 1950 the average age of menarche was 12.5 years, and in the decades 1990 and 2000 the average age is 12 with a difference of 0.5 months with a p statistically significant 0.0002. There was no relationship between the age of menarche and the presence of factors of Metabolic risk in the participants (this analysis included only people older than 45 years); but it was found in women with early menarche higher proportion of obesity than in those with menarche at normal and late ages (57.14%, 26.8%, 38.8%), with a statistically significant P (p = 0.036). Conclusion: The present study was consistent with other studies in the variation associated with an increasingly younger age of menarche. It draws attention that the epidemiological change described in other countries where it has already reached plateau as in North America in the 1960s and Europe in 1994, our findings show that in Colombia the descent continues on a slope and without approaching a plateau, it is also very clear that unlike the United States and Europe it mark in a significant way the difference in the descent and this merits other studies to determine the veracity and the cause of this behavior. At the level of the exploration in the cardiovascular risk it was not found important differences, only in women with early menarche greater proportion of obesity. Limitations: Being a study of a single site in Bogotá that has a population of strata 3 to 6, only includes a part of the Colombian population, and as for the Approximation of cardiovascular risk requires further studies focused on patients with extreme changes of menarche.