<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE root>
<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="review-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Obstetrics and Gynecology</journal-id><journal-title-group><journal-title xml:lang="en">Obstetrics and Gynecology</journal-title><trans-title-group xml:lang="ru"><trans-title>Акушерство и гинекология</trans-title></trans-title-group></journal-title-group><issn publication-format="print">0300-9092</issn><issn publication-format="electronic">2412-5679</issn><publisher><publisher-name xml:lang="en">Bionika Media</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">690381</article-id><article-id pub-id-type="doi">10.18565/aig.2025.107</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Reviews</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Обзоры</subject></subj-group><subj-group subj-group-type="article-type"><subject>Review Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Characteristics of the menstrual cycle in obese adolescent girls</article-title><trans-title-group xml:lang="ru"><trans-title>Особенности менструального цикла у девочек-подростков с ожирением</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0009-5092-4408</contrib-id><name-alternatives><name xml:lang="en"><surname>Serikbaeva</surname><given-names>Ainash T.</given-names></name><name xml:lang="ru"><surname>Серикбаева</surname><given-names>Айнаш Толеубековна</given-names></name></name-alternatives><address><country country="KZ">Kazakhstan</country></address><bio xml:lang="en"><p>2nd-Year PhD Student, Assistant at the Department of Obstetrics and Gynecology No. 1</p></bio><bio xml:lang="ru"><p>PhD-докторант 2-го года обучения, ассистент кафедры акушерства и гинекологии №1</p></bio><email>seraintol5@gmail.com</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0410-817X</contrib-id><name-alternatives><name xml:lang="en"><surname>Kakhiani</surname><given-names>Ekaterina I.</given-names></name><name xml:lang="ru"><surname>Кахиани</surname><given-names>Екатерина Инвериевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology named after S.N. Davydov</p></bio><bio xml:lang="ru"><p>д.м.н., профессор, заведующая кафедрой акушерства и гинекологии им. С.Н. Давыдова</p></bio><email>dr.ekaterina@mail.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0902-5269</contrib-id><name-alternatives><name xml:lang="en"><surname>Khamidullina</surname><given-names>Zaituna G.</given-names></name><name xml:lang="ru"><surname>Хамидуллина</surname><given-names>Зайтуна Гадиловна</given-names></name></name-alternatives><address><country country="KZ">Kazakhstan</country></address><bio xml:lang="en"><p>PhD, Professor, Head of the Department of Obstetrics and Gynecology No. 1</p></bio><bio xml:lang="ru"><p>к.м.н., профессор, заведующая кафедрой акушерства и гинекологии №1</p></bio><email>zaituna59@gmail.com</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5410-7781</contrib-id><name-alternatives><name xml:lang="en"><surname>Akhmedyanova</surname><given-names>Gainyl U.</given-names></name><name xml:lang="ru"><surname>Ахмедьянова</surname><given-names>Гайныл Угубаевна</given-names></name></name-alternatives><address><country country="KZ">Kazakhstan</country></address><bio xml:lang="en"><p>PhD, Professor, Department of Obstetrics and Gynecology No. 1</p></bio><bio xml:lang="ru"><p>к.м.н., профессор кафедры акушерства и гинекологии №1</p></bio><email>akhmedyanova.gaynyl@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Astana Medical University</institution></aff><aff><institution xml:lang="ru">НАО «Медицинский Университет Астана»</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia</institution></aff><aff><institution xml:lang="ru">ФГБОУ ВО «Северо-Западный государственный медицинский университет имени И.И. Мечникова» Минздрава России</institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2025-09-26" publication-format="electronic"><day>26</day><month>09</month><year>2025</year></pub-date><issue>8</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>48</fpage><lpage>56</lpage><history><date date-type="received" iso-8601-date="2025-09-15"><day>15</day><month>09</month><year>2025</year></date><date date-type="accepted" iso-8601-date="2025-09-15"><day>15</day><month>09</month><year>2025</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2025, Bionika Media</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2025, ООО «Бионика Медиа»</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="en">Bionika Media</copyright-holder><copyright-holder xml:lang="ru">ООО «Бионика Медиа»</copyright-holder></permissions><self-uri xlink:href="https://journals.eco-vector.com/0300-9092/article/view/690381">https://journals.eco-vector.com/0300-9092/article/view/690381</self-uri><abstract xml:lang="en"><p><bold>Background:</bold> In recent decades, there has been a steady increase in the body mass index (BMI) among children and adolescents worldwide that reflects the growing prevalence of obesity at a young age. Excess body weight during this sensitive period of development has a significant impact on the reproductive system of adolescent girls. In this regard, early diagnosis and prevention of overweight-related disorders are of particular importance, as they help minimize potential risks and contribute to a healthy reproductive future.</p> <p><bold>Objective:</bold> To analyze the data of the foreign studies on the role of obesity in the development of menstrual cycle disorders in adolescents.</p> <p><bold>Materials and methods:</bold> This literature review analyzes studies published over the past 10 years including reviews, cohort studies and meta-analyses, on the risk factors, diagnosis, and prevention of ovarian dysfunction in obese girls. A total of 42 publications were included in the review out of 89 articles found on the issue. The search for scientific publications was conducted in databases of Elsevier, PubMed, and Web of Science using keywords related to obesity and menstrual disorders in adolescents.</p> <p><bold>Results:</bold> The analysis of literature and data of epidemiological studies has shown that high values of BMI, waist circumference and hip circumference significantly correlate with the duration, volume, and regularity of menstruation, as well as the severity of pain syndrome. Obese adolescents are more likely to suffer from oligomenorrhea, heavy menstrual bleeding, dysmenorrhea, and premenstrual disorders. These findings highlight the need for early screening of body weight and metabolic status in girls for timely prevention and correction of reproductive disorders.</p> <p><bold>Conclusion:</bold> The diagnosis of obesity in adolescents requires a comprehensive approach including the analysis of the patient’s medical history, the assessment of the diet and lifestyle, and screening for obesity, hypertension, hyperglycemia, and dyslipidemia.</p></abstract><trans-abstract xml:lang="ru"><p><bold>Актуальность:</bold> За последние десятилетия во всем мире наблюдается устойчивая тенденция к росту индекса массы тела (ИМТ) среди детей и подростков, что отражает нарастающий масштаб проблемы ожирения в юном возрасте. Избыточная масса тела в этот чувствительный период развития оказывает значительное влияние на репродуктивную систему девочек-подростков. В этой связи особое значение приобретает ранняя диагностика и профилактика нарушений, связанных с избыточным весом, что позволяет минимизировать потенциальные риски и способствует формированию благополучного репродуктивного будущего.</p> <p><bold>Цель: </bold>Проанализировать данные зарубежных исследований, посвященных роли ожирения в формировании нарушений менструального цикла у подростков.</p> <p><bold>Материалы и методы:</bold> В данном литературном обзоре проанализированы исследования, опубликованные за последние 10 лет, в том числе обзорные работы, когортные исследования и метаанализы, касающиеся факторов риска, диагностики и профилактики овариальной дисфункции у девочек с ожирением. Из 89 найденных публикаций в обзор было включено 42 зарубежных исследования.</p> <p>Поиск научных публикаций был проведен в базах данных Elsevier, PubMed и Web of Science с использованием ключевых слов, связанных с ожирением и нарушениями менструального цикла у подростков.</p> <p><bold>Результаты: </bold>Анализ литературы и данных эпидемиологических исследований показали, что высокие значения ИМТ, окружности талии и бедер достоверно коррелируют с продолжительностью, объемом и регулярностью менструаций, а также с выраженностью болевого синдрома. Подростки с ожирением чаще страдают от олигоменореи, обильного менструального кровотечения, дисменореи и предменструальных расстройств. Эти данные подчеркивают необходимость раннего скрининга массы тела и метаболического статуса у девочек для своевременной профилактики и коррекции репродуктивных нарушений.</p> <p><bold>Заключение:</bold> Диагностика ожирения у подростков требует комплексного подхода, включающего анализ анамнеза, оценку питания и образа жизни, а также обследование на предмет ожирения, артериальной гипертензии, гипергликемии и дислипидемии.</p></trans-abstract><kwd-group xml:lang="en"><kwd>obesity</kwd><kwd>menstrual disorder</kwd><kwd>puberty</kwd><kwd>sexual development</kwd><kwd>adolescents</kwd><kwd>adolescent girls</kwd><kwd>metabolic syndrome</kwd><kwd>ovarian dysfunction</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>ожирение</kwd><kwd>нарушение менструального цикла</kwd><kwd>пубертат</kwd><kwd>половое развитие</kwd><kwd>подростки</kwd><kwd>девочки-подростки</kwd><kwd>метаболический синдром</kwd><kwd>овариальная дисфункция</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Wood P.L., Bauman D. Gynaecological issues affecting the obese adolescent. Best Pract. Res. Clin. Obstet. Gynaecol. 2015; 29(4): 453-65. https://dx.doi.org/10.1016/j.bpobgyn.2014.10.015</mixed-citation></ref><ref id="B2"><label>2.</label><mixed-citation>Centers for Disease Control and Prevention. Childhood obesity. Available at: https://www.cdc.gov/obesity/childhood-obesity-facts/childhood-obesity-facts.html?CDC_AAref_Val = https://www.cdc.gov/obesity/data/childhood.html</mixed-citation></ref><ref id="B3"><label>3.</label><mixed-citation>World Health Organizaton. Report on the fifth round of data collection, 2018–2020: WHO European Childhood Obesity Surveillance Initiative (COSI). Available at: https://www.who.int/europe/publications/i/item/ WHO-EURO-2022-6594-46360-67071</mixed-citation></ref><ref id="B4"><label>4.</label><mixed-citation>Elizondo-Montemayor L., Hernández-Escobar C., Lara-Torre E., Nieblas B., Gómez-Carmona M. Gynecologic and obstetric consequences of obesity in adolescent girls. J. Pediatr. Adolesc. Gynecol. 2017; 30(2): 156-68. https://dx.doi.org/10.1016/j.jpag.2016.02.007</mixed-citation></ref><ref id="B5"><label>5.</label><mixed-citation>Skinner A.C., Ravanbakht S.N., Skelton J.A., Perrin E.M., Armstrong S.C. Prevalence of obesity and severe obesity in US children, 1999–2016. Pediatrics. 2018; 141(3): e20173459. https://dx.doi.org/10.1542/peds.2017-3459</mixed-citation></ref><ref id="B6"><label>6.</label><mixed-citation>NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet. 2017; 390(10113): 2627-42. https:// dx.doi.org/10.1016/S0140-6736(17)32129-3</mixed-citation></ref><ref id="B7"><label>7.</label><mixed-citation>Breda J., Farrugia Sant’Angelo V., Duleva V., Galeone D., Heinen M.M., Kelleher C.C. et al. Mobilizing governments and society to combat obesity: reflections on how data from the WHO European Childhood Obesity Surveillance Initiative are helping to drive policy progress. Obes. Rev. 2021; 22(S6): e13217. https://dx.doi.org/10.1111/obr.13217</mixed-citation></ref><ref id="B8"><label>8.</label><mixed-citation>Аскаров К.К., Абдрахманова Ш.З., Слажнева Т.И., Адаева А.А., Калмакова Ж.А., Акимбаева А.А., Сулейманова Н.А. Эпидемиологический надзор за детским ожирением, питанием и физической активностью в Республике Казахстан. Национальный отчет, 2020 год. Нур-Султан: НЦОЗ МЗ РК; 2022. 42 с. [Askarov K.K., Abdrakhmanova Sh.Z., Slazhneva T.I., Adayeva A.A., Kalmakova Zh.A., Akimbaeva A.A., Suleymanova N.A. Epidemiological surveillance of childhood obesity, nutrition, and physical activity in the Republic of Kazakhstan. National report, 2020. Nur-Sultan: NCSD of the Ministry of health of the Republic of Kazakhstan; 2022. 42 p. (in Russian)].</mixed-citation></ref><ref id="B9"><label>9.</label><mixed-citation>Gritsinskaya V.L., Novikova V.P. Obesity in children in the redions of Russia. Arch. Dis. Child. 2021; S2(106): A87.1-A87. https://dx.doi.org/10.1136/archdischild-2021-europaediatrics.205</mixed-citation></ref><ref id="B10"><label>10.</label><mixed-citation>Грицинская В.Л., Новикова В.П., Хавкин А.И. К вопросу об эпидемиологии ожирения у детей и подростков (систематический обзор и мета-анализ научных публикаций за 15-летний период). Вопросы практической педиатрии. 2022; 2(17): 126-35. [Gritsinskaya V.L., Novikova V.P., Khavkin A.I. Epidemiology of obesity in children and adolescents (systematic review and metaanalysis of publications over a 15-year period). Clinical practice in pediatrics. 2022; 17(2): 126-35 (in Russian)]. https://dx.doi.org/10.20953/ 1817-7646-2022-2-126-135</mixed-citation></ref><ref id="B11"><label>11.</label><mixed-citation>Tenedero C.B., Oei K., Palmert M.R. An approach to the evaluation and management of the obese child with early puberty. J. Endocr. Soc. 2021; 6(1): bvab173. https://dx.doi.org/10.1210/jendso/bvab173</mixed-citation></ref><ref id="B12"><label>12.</label><mixed-citation>Javed A., Jumean M., Murad M.H., Okorodudu D., Kumar S., Somers V.K. et al. Diagnostic performance of body mass index to identify obesity as defined by body adiposity in children and adolescents: a systematic review and meta-analysis. Pediatr. Obes. 2015; 10(3): 234-44. https://dx.doi.org/10.1111/ ijpo.242</mixed-citation></ref><ref id="B13"><label>13.</label><mixed-citation>Simmonds M., Llewellyn A., Owen C.G., Woolacott N. Predicting adult obesity from childhood obesity: a systematic review and meta-analysis. Obes. Rev. 2016; 17(2): 95-107. https://dx.doi.org/10.1111/obr.12334</mixed-citation></ref><ref id="B14"><label>14.</label><mixed-citation>Skinner A.C., Staiano A.E., Armstrong S.C., Barkin S.L., Hassink S.G., Moore J.E. et al. Appraisal of clinical care practices for child obesity treatment. Part I: Interventions. Pediatrics. 2023; 151(2): e2022060642. https://dx.doi.org/10.1542/peds.2022-060642</mixed-citation></ref><ref id="B15"><label>15.</label><mixed-citation>Skinner A.C., Perrin E.M., Moss L.A., Skelton J.A. Cardiometabolic risks and severity of obesity in children and young adults. N. Engl. J. Med. 2015; 373(14): 1307-17. https://dx.doi.org/10.1056/NEJMoa1502821</mixed-citation></ref><ref id="B16"><label>16.</label><mixed-citation>Poddar M., Chetty Y., Chetty V.T. How does obesity affect the endocrine system? A narrative review. Clin. Obes. 2017; 7(3): 136-44. https://dx.doi.org/10.1111/cob.12184</mixed-citation></ref><ref id="B17"><label>17.</label><mixed-citation>Berardis S., Sokal E. Pediatric non-alcoholic fatty liver disease: an increasing public health issue. Eur. J. Pediatr. 2014; 173(2): 131-9. https://dx.doi.org/10.1007/s00431-013-2157-6</mixed-citation></ref><ref id="B18"><label>18.</label><mixed-citation>Pulgaron E.R., Delamater A.M. Obesity and type 2 diabetes in children: epidemiology and treatment. Curr. Diab. Rep. 2014; 14(8): 508. https://dx.doi.org/10.1007/s11892-014-0508-y</mixed-citation></ref><ref id="B19"><label>19.</label><mixed-citation>Skelton J.A., Klish W.J. Clinical evaluation of the child or adolescent with obesity. UpToDate. Available at: https://www.uptodate.com/contents/clinical-evaluation-of-the-child-or-adolescent-with-obesity?search=3.%09Joseph%20A%20Skelton%2C%20MD%2C%20MSWilliam%20J%20Klish%2C%20MD%20Clinical%20evaluation%20of%20the%20child%20or%20adolescent%20with%20obesity%20%20&amp;source = search_result&amp;selectedTitle = 1%7E150&amp;usage_type = default&amp;display_rank = 1</mixed-citation></ref><ref id="B20"><label>20.</label><mixed-citation>Itriyeva K. The effects of obesity on the menstrual cycle. Curr. Probl. Pediatr. Adolesc. Health Care. 2022; 52(8): 101241. https://dx.doi.org/10.1016/ j.cppeds.2022.101241</mixed-citation></ref><ref id="B21"><label>21.</label><mixed-citation>Deligeoroglou E., Karountzos V. The correlation between abnormal uterine bleeding in early menarche and PCOS later in adolescence. In: Genazzani A.R., Goldstein S., Simoncini T., eds. Menstrual bleeding and pain disorders from adolescence to menopause. Vol. 11. Cham: Springer; 2024: 39-51. https://dx.doi.org/10.1007/978-3-031-55300-4_4</mixed-citation></ref><ref id="B22"><label>22.</label><mixed-citation>Rad M., Sabzevary M.T., Dehnavi Z.M. Association between menstrual disorders and obesity-related anthropometric indices in female high school students: a cross-sectional study. International Journal of School Health. 2018; 5(2): e65716. https://dx.doi.org/10.5812/intjsh.65716</mixed-citation></ref><ref id="B23"><label>23.</label><mixed-citation>Reavey J.J., Walker C., Murray A.A., Brito-Mutunayagam S., Sweeney S., Nicol M. et al. Obesity is associated with heavy menstruation that may be due to delayed endometrial repair. J. Endocrinol. 2021; 249(2): 71-82. https://dx.doi.org/10.1530/JOE-20-0446</mixed-citation></ref><ref id="B24"><label>24.</label><mixed-citation>Kafaei-Atrian M., Mohebbi-Dehnavi Z., Sayadi L., Asghari-Jafarabadi M., Karimian-Taheri Z., Afshar M. The relationship between the duration of menstrual bleeding and obesity-related anthropometric indices in students. J. Educ. Health Promot. 2019; 8: 81. https://dx.doi.org/10.4103/ jehp.jehp_24_18</mixed-citation></ref><ref id="B25"><label>25.</label><mixed-citation>Mendiratta V., Lentz G.M. Primary and secondary dysmenorrhea, premenstrual syndrome, and premenstrual dysphoric disorder. In: Lobo R.A., Gershenson D.M., Lentz G.M., eds. Comprehensive gynecology. 7th ed. Philadelphia (PA): Elsevier Inc.; 2022: 768-780.e4. https://doi.org/10.1016/B978-0-323-65399-2.00044-9</mixed-citation></ref><ref id="B26"><label>26.</label><mixed-citation>Bernardi M., Lazzeri L., Perelli F., Reis F.M., Petraglia F. Dysmenorrhea and related disorders. F1000Res. 2017; 6: 1645. https://dx.doi.org/10.12688/f1000research.11682.1</mixed-citation></ref><ref id="B27"><label>27.</label><mixed-citation>Jusuf E.C., Octaviani D., Husain M.G., Sudirman J. The influence of physical activity, body mass index and urinary levels of prostaglandin (PGF2α) with the incidence of primary dysmenorrhea in adolescents. J. Obstet. Gynaecol. Res. 2024; 50(5): 909-13. https://dx.doi.org/10.1111/jog.15914</mixed-citation></ref><ref id="B28"><label>28.</label><mixed-citation>Kushwah A., Jungari M.L., Shrivastava D., Joshi A. Study of pattern of menstrual disorders in adolescent girls at tertiary care centre in peri-urban area of Central India. Annals of R.S.C.B. 2021; 4(25): 7147-55. https://annalsofrscb.ro/ index.php/journal/article/view/3329/2755</mixed-citation></ref><ref id="B29"><label>29.</label><mixed-citation>Rafique N., Al-Sheikh M.H. Prevalence of primary dysmenorrhea and its relationship with body mass index. J. Obstet. Gynaecol. Res. 2018; 44(9): 1773-8. https://dx.doi.org/10.1111/jog.13697</mixed-citation></ref><ref id="B30"><label>30.</label><mixed-citation>Smith J.D., Fu E., Kobayashi M.A. Prevention and management of childhood obesity and its psychological and health comorbidities. Annu. Rev. Clin. Psychol. 2020; 16: 351-78. https://dx.doi.org/10.1146/annurev-clinpsy-100219-060201</mixed-citation></ref><ref id="B31"><label>31.</label><mixed-citation>Takata K., Kotani K., Umino H. The relationship between body mass index and dysmenorrhea in the general female population. J. Clin. Med. Res. 2023; 15(4): 239-42. https://dx.doi.org/10.14740/jocmr4893</mixed-citation></ref><ref id="B32"><label>32.</label><mixed-citation>Taheri R., Ardekani F.M., Shahraki H.R., Heidarzadeh-Esfahani N., Hajiahmadi S. Nutritional status and anthropometric indices in relation to menstrual disorders: a cross-sectional study. J. Nutr. Metab. 2020; 2020: 5980685. https://dx.doi.org/10.1155/2020/5980685</mixed-citation></ref><ref id="B33"><label>33.</label><mixed-citation>Андреева Е.Н., Григорян О.Р. Эндокринная гинекология: избранные семинары. М.: МЕДпресс-информ; 2023. 436 с. [Andreeva E.N., Grigoryan O.R. Endocrine gynecology: selected seminars. Moscow: MEDpress-Inform; 2023. 436 p. (in Russian)].</mixed-citation></ref><ref id="B34"><label>34.</label><mixed-citation>Tsinopoulou V.R., Bacopoulou F., Fidani S., Christoforidis A. Genetic determinants of age at menarche: does the LIN28B gene play a role? A narrative review. Hormones (Athens). 2025; 24(1): 167-77. https://dx.doi.org/10.1007/ s42000-024-00594-3</mixed-citation></ref><ref id="B35"><label>35.</label><mixed-citation>Holmgren A., Niklasson A., Nierop A.F., Gelander L., Aronson A.S., Sjöberg A. Pubertal height gain is inversely related to peak BMI in childhood. Pediatr. Res. 2017; 81(3): 448-54. https://dx.doi.org/10.1038/pr.2016.253</mixed-citation></ref><ref id="B36"><label>36.</label><mixed-citation>Reinehr T., Roth C.L. Is there a causal relationship between obesity and puberty? Lancet Child Adolesc. Health. 2019; 3(1): 44-54. https://dx.doi.org/10.1016/S2352-4642(18)30306-7</mixed-citation></ref><ref id="B37"><label>37.</label><mixed-citation>Aris I.M., Rifas-Shiman S.L., Zhang X., Yang S., Switkowski K., Fleisch A.F. Association of BMI with Linear growth and pubertal development. Obesity (Silver Spring). 2019; 27(10): 1661-70. https://dx.doi.org/10.1002/ oby.22592</mixed-citation></ref><ref id="B38"><label>38.</label><mixed-citation>Li Y., Ma T., Ma Y., Gao D., Chen L., Chen M. Adiposity status, trajectories, and earlier puberty onset: results from a longitudinal cohort study. J. Clin. Endocrinol. Metab. 2022; 107(9): 2462-72. https://dx.doi.org/10.1210/clinem/dgac395</mixed-citation></ref><ref id="B39"><label>39.</label><mixed-citation>Durda-Masny M., Hanć T., Czapla Z., Szwed A. BMI at menarche and timing of growth spurt and puberty in Polish girls – longitudinal study. Anthropol. Anz. 2019; 76(1): 37-47. https://dx.doi.org/10.1127/anthranz/2019/0920</mixed-citation></ref><ref id="B40"><label>40.</label><mixed-citation>Rafique N., AlSheikh M.H. Identifying menarcheal age and its association with body mass index in young Saudi females. Saudi Med. J. 2019; 40(9): 958-61. https://dx.doi.org/10.15537/smj.2019.9.24425</mixed-citation></ref><ref id="B41"><label>41.</label><mixed-citation>Yüksel M., Yüksel E. The effect of obesity on the menstrual period and hormonal parameters. Turkish Journal of Health Science and Life. 2019; 2(2): 25-30. https://dergipark.org.tr/tr/download/article-file/912949</mixed-citation></ref><ref id="B42"><label>42.</label><mixed-citation>Akhila G., Shaik A., Kumar R.D. Current factors affecting the menstrual cycle. International Journal of Research in Hospital and Clinical Pharmacy. 2020; 2: 18-21. https://dx.doi.org/10.33974/ijrhcp.v2i1.165</mixed-citation></ref><ref id="B43"><label>43.</label><mixed-citation>Hossam H., Fahmy N., Khidr N., Marzouk T. The relationship between menstrual cycle irregularity and body mass index among secondary schools pupils. IOSR J. Nurs. Health Sci. 2016; 5(1): 48-52. https://dx.doi.org/10.9790/1959-05154852</mixed-citation></ref><ref id="B44"><label>44.</label><mixed-citation>He Y., Tian J., Blizzard L., Oddy W.H., Dwyer T., Bazzano L.A. et al. Associations of childhood adiposity with menstrual irregularity and polycystic ovary syndrome in adulthood: the Childhood Determinants of Adult Health Study and the Bogalusa Heart Study. Hum. Reprod. 2020; 35(5): 1185-98. https:// dx.doi.org/10.1093/humrep/deaa069</mixed-citation></ref><ref id="B45"><label>45.</label><mixed-citation>World Health Organization. Obesity and overweight. Available at: www.who.int/news-room/fact-sheets/detail/obesity-and-overweight</mixed-citation></ref><ref id="B46"><label>46.</label><mixed-citation>Lu D., Aleknaviciute J., Kamperman A.M., Tamimi R.M., Ludvigsson J.F., Valdimarsdóttir U.A. et al. Association between childhood body size and premenstrual disorders in young adulthood. JAMA Netw. Open. 2022; 5(3): e221256. https://dx.doi.org/10.1001/jamanetworkopen.2022.1256</mixed-citation></ref><ref id="B47"><label>47.</label><mixed-citation>Ju H., Jones M., Mishra G.D. Premenstrual syndrome and dysmenorrhea: symptom trajectories over 13 years in young adults. Maturitas. 2014; 78(2): 99-105. https://dx.doi.org/10.1016/j.maturitas.2014.03.008</mixed-citation></ref><ref id="B48"><label>48.</label><mixed-citation>Nisa J., Hidayah S., Izzah N. Premenstrual syndrome based on physical activity, body mass index and blood pressure in adolescent girls. Jurnal Kesehatan Reproduksi. 2023; 3(10): 186-92. https://dx.doi.org/10.22146/jkr.77308</mixed-citation></ref><ref id="B49"><label>49.</label><mixed-citation>Hampl S.E., Hassink S.G., Skinner A.C., Armstrong S.C., Barlow S.E., Bolling C.F. et al. Clinical practice guideline for the evaluation and treatment of children and adolescents with obesity. Pediatrics. 2023; 151(2): e2022060640. https:// dx.doi.org/10.1542/peds.2022-060640</mixed-citation></ref></ref-list></back></article>
