Association between Body Mass Index, age at Menarche with Skeletal Maturity Indicators using Hand Wrist Radiograph in Bengali Female Population: A Cross-sectional Study

Introduction: Estimation and use of craniofacial growth is crucial in addressing skeletal discrepancies for orthodontic correction of young and growing children. It is crucial to determine each patient’s skeletal age and compare it to their dental and chronological ages before diagnosing a proper treatment plan. An essential biological indicator for determining a female’s physiologic maturity is her age at puberty. Menarche and hand wrist skeletal maturation can be used to determine the beginning and conclusion of the pubertal growth spurt. Aim: To find association between Body Mass Index (BMI), age at menarche with hand-wrist radiograph in Bengali fe Materials and Methods: The present cross-sectional study was conducted at Department of Orthodontics and Dentofacial Orthopaedics in collaboration with the Department of Pedodontics, Guru Nanak Institute of Dental Sciences and Research, Kolkata, India from March 2022 to January 2024. Hundred subjects were evaluated in the age range of 9-15 years. Subjects’ menarcheal age, BMI and Skeletal Maturity Indicators (SMI) using hand wrist X-ray were assessed and tabulated. Statistical analysis was done to find association between these three parameters. (GraphPad Prism Software version 9.5, LaJolla, California) was used for analysis. Parametric tests, Oneway Analysis of Variance (ANOVA), Post-hoc Tukey’s and Chisquare (χ2 ) test were used for inferential statistics. Results: The mean menarche age of subjects were 12.2±1.2 years. It was observed that obese girls had the onset of menarche at an early stage (10.06±0.35 years), followed by overweight girls (11.15±0.72 years), normal weight girls (12.73±0.68 years), and then underweight girls who had their menarche at 14.2±0.14 years; p<0.001*. Higher skeletal maturity (stage VII, VIII), 40%, 42.5%, respectively was achieved only at higher age groups and was dependent on the age at menarche (p<0.001**). BMI showed an inverse association to skeletal maturity. Subjects with healthy BMI (healthy) showed good skeletal maturation rate. Conclusion: Obese girls experienced menstruation earlier as compared to healthy and underweight girls. Data indicated that menarche and BMI percentile were inversely associated. Significant statistical relation was seen in between the BMI percentile and the SMI and between peak pubertal growth assessed by hand-wrist X-ray as SMI and the menarche onset.