초등학교 여학생의 초경시기와 관련된 결정요인 분석

Purpose: During the recent decades, the age at menarche continued to decline in Korea and worldwide. Prior studies have suggested that early menarche may increase the risk of various social, psychological, and physical health problems in young adolescent girls, but little is known about the determinants associated with early menarche. The purpose of this study is to evaluate independent determinants of early menarche among 5th~6th female graders in South Korea. Methods: Our analysis was conducted in 95 menarcheal girls and 95 age-matched pre-menarcheal girls residing in Daegu, South Korea. Demographic and lifestyle characteristics were collected using survey questionnaires for children and parents. Dietary information was assessed by 2 day~24 hour food records and survey questionnaires, which were completed by both children and their parents. Anthropometric data were obtained from the student health check-ups at the school. Results: A multiple logistic regression analysis using a conditional likelihood method was performed for simultaneous evaluation of several risk factors. There were significant differences in that higher proportion of obesity (OR, odds ratio = 5.60, 95% CI, confidence interval = 1.34~23.42), shorter sleep duration (OR = 0.45, 95% CI = 0.23~0.87), and younger mother's age at menarche (OR = 0.64, 95% CI = 0.44~0.93) were observed in the menarcheal group compared to the pre-menarcheal group. Conclusion: These findings indicate a possible association of sleep duration, mother's menarcheal age, and obesity with age at menarche. A well-planned, prospective cohort study is warranted to examine causal relationship. 본 연구는 초경시기의 결정요인을 규명하기 위하여 대구 3개 지역 초등학교 5, 6학년 여학생 190명을 대상으로 개별 짝짓기 환자-대조군 연구를 실시하였고, 본 연구 결과를 요약하면 다음과 같다. 첫째, 비초경군에 비하여 초경군의 평균 수면시간이 더 적었다. 둘째, 어머니의 초경 나이가 빠를 수록 같은 또래에 비해 더 이른 초경 경험을 할 확률이 높았다. 셋째, 초경시기와 관련된 요인 중 비만이 가장 강한 연관성을 보였다. 전 세계적으로 초경 나이가 낮아지는 경향을 보이고 있으며, 우리나라 여성의 초경 나이도 현저하게 낮아지는 상황에서 본 연구의 결과는 중요한 기초자료로 활용될 것이다.