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Discrete-time Survival Analysis of Risk Factors for Early Menarche in Korean Schoolgirls
Yong Jin Gil, Jong Hyun Park, Joohon Sung
J Prev Med Public Health. 2023;56(1):59-66.   Published online December 29, 2022
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AbstractAbstract AbstractSummary PDF
The aim of this study was to evaluate the effect of body weight status and sleep duration on the discrete-time hazard of menarche in Korean schoolgirls using multiple-point prospective panel data.
The study included 914 girls in the 2010 Korean Children and Youth Panel Study who were in the elementary first-grader panel from 2010 until 2016. We used a Gompertz regression model to estimate the effects of weight status based on age-specific and sex-specific body mass index (BMI) percentile and sleep duration on an early schoolchild’s conditional probability of menarche during a given time interval using general health condition and annual household income as covariates.
Gompertz regression of time to menarche data collected from the Korean Children and Youth Panel Study 2010 suggested that being overweight or sleeping less than the recommended duration was related to an increased hazard of menarche compared to being average weight and sleeping 9 hours to 11 hours, by 1.63 times and 1.38 times, respectively, while other covariates were fixed. In contrast, being underweight was associated with a 66% lower discrete-time hazard of menarche.
Weight status based on BMI percentiles and sleep duration in the early school years affect the hazard of menarche.
Korean summary
초경연령의 조기화는 세계적인 현상이나 유독 우리나라에서는 그 단축속도가 매우 빠르나. 그 위험요인은 비만 이외에 확립되어 있지 못하다. 본 연구는 한국아동청소년패널의 2010-16년도까지 추적관찰된 914 명의 여아 자료를 Gompetz 회귀모형 (다중 분절형 생존분석모형)을 통해 분석하였며, 그 결과 과체중은 1년의 초경연령 단축을 유발할 위험도가 정상체중 여아에 비해 1.63배, 수면시간이 충분하지 못한 여아는 충분한 수면을 취하는 여아에 비해 1년의 초경연령 단축이 발생할 위험도가 1.38배 높은 것으로 나타났다.
Relationship Between Body Mass Index and Early Menarche of Adolescent Girls in Seoul
Chang-Mo Oh, In-Hwan Oh, Kyung-Sik Choi, Bong-Keun Choe, Tai-Young Yoon, Joong-Myung Choi
J Prev Med Public Health. 2012;45(4):227-234.   Published online July 31, 2012
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  • 26 Crossref
AbstractAbstract PDF

The object of this study was to determine the relationship between body mass index (BMI) and early menarche in adolescent girls in Seoul.


A retrospective study was conducted with 144 middle school students in Seoul who provided informed consent. We measured their body composition, and used the questionnaire survey method for data collection from November to December 2008. Past elemental body composition data were collected from elementary school health records of first year of middle school.


The early menarcheal group was taller and heavier than the late menarcheal group (p<0.05 from 8-12 years old). The body fat percentage (%), BMI were higher in the early menarcheal girls than the late-menarcheal girls (p<0.05, age at 13). In the result of multiple logistic regression, the BMI at the age of 8 and 9 was associated with early menarche after adjusting for birth weight, breast feeding and age at menarche of the mother (BMI at the age of 8: p for trend=0.01, BMI at the age of 9: p for trend=0.04). An increase in BMI from 7 to 8 year was associated with early menarche after adjusting for birth weight, breast feeding, age at menarche of the mother (p for trend=0.048).


The BMI at the age of 8 and 9 was associated with the early menarche of girls and increase in BMI from 7 to 8 year was associated with the early menarche of girls. These results suggest that BMI and increase in BMI before menarche cause early menarche. Although this study does not represent all Korean adolescent girls, it is one of the few studies that have investigated the temporal relationship between BMI and early menarche.



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Timing of Menarche and Physical Growth during Childhood and Adolescence: The Kangwha Study.
Chang Soo Kim, Chung Mo Nam, Duck Hi Kim, Hyun Chang Kim, Kang Hee Lee, Sun Ha Jee, Il Suh
Korean J Prev Med. 2000;33(4):521-529.
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  • 30 Download
AbstractAbstract PDF
To assess height, weight and body mass index from childhood to adolescence according to the age at menarche and hence to study the influence of childhood growth on the menarche age. METHODS: "The Kangwha Study" was a community-based prospective cohort study which included the entire population of 219 female first graders in Kangwha county in 1986. Among the 219 girls, 119 girls who had received complete follow up checks during the study period(1986~1997), were included in this study, except one for whom menarche age information was unavailable. The remaining 118 girls were divided into three groups according to the timing of menarche : early(<25 percentile), intermediate and late(> or =75 percentile) maturers. RESULTS: The average age at menarche was 12.7 years : early 11.3 years, intermediate 12.6 years and late 13.7 years. The early maturers were taller and heavier between 6~8 years. But, the mean weight and body mass index at the menarche age did not differ statistically among the three groups. The weight and body mass index of the early maturers were consistently higher than those of the late maturers over the entire period of the study. CONCLUSIONS: Critical body weight and body mass index must be attained for menstruation to be attained and the age at menarche is largely determined by the childhood growth. In addition, it seems that childhood growth and age at menarche are associated with adolescent weight and body mass index.

JPMPH : Journal of Preventive Medicine and Public Health