title: First assessment of menstrual cycle function and reproductive endocrine status in Samoan women.
abstract: BACKGROUND
  American Samoa and Samoa are now characterized by one of the world's highest levels of adult overweight and obesity. Our objective was to investigate patterns of menstrual cyclicity reported by Samoan women and examine the relationship to adiposity and select hormone levels.
  
  
  METHODS
  A cross-sectional analysis was performed among Samoan women, aged 18-39 years (n = 322), using anthropometric and biomarker measures of adiposity and reproductive health, including insulin, adiponectin, testosterone, sex hormone-binding globulin, free androgen index (FAI) and mullerian-inhibiting substance (MIS). Menstrual regularity was assessed from self-reported responses. Multivariable models were estimated to adjust for potential confounding of the associations between menstrual patterns and other measures.
  
  
  RESULTS
  A high proportion of the women (13.7%) reported oligomenorrhea or amenorrhea (OM/AM). More than three-quarters, 80.7%, of women were either overweight or obese, using Polynesian-specific criteria, and OM/AM was significantly associated with higher BMI. Abdominal circumference and insulin levels were significantly higher, and adiponectin levels were lower, in those who reported OM/AM versus regular menstruation. The FAI was higher in women with increased BMI. MIS levels declined with age, more slowly in those reporting OM/AM.
  
  
  CONCLUSIONS
  Self-reported OM/AM was associated with an elevated BMI, abdominal adiposity and serum insulin, and with reduced adiponectin levels. These findings support a high rate of metabolic syndrome, and perhaps PCOS and reproductive dysfunction, among Samoan women.
authors.affiliation: Department of Pathology and Laboratory Medicine, Alpert Medical School of Brown University, Providence, RI 02912, USA. gmesserl@wihri.org
authors.forename: G
authors.initials: G
authors.lastname: Lambert-Messerlian
authors.forename: M B
authors.initials: MB
authors.lastname: Roberts
authors.forename: S S
authors.initials: SS
authors.lastname: Urlacher
authors.forename: J
authors.initials: J
authors.lastname: Ah-Ching
authors.forename: S
authors.initials: S
authors.lastname: Viali
authors.forename: M
authors.initials: M
authors.lastname: Urbanek
authors.forename: S T
authors.initials: ST
authors.lastname: McGarvey
mesh_terms: D052242:Adiponectin / Q000097:blood; D050154:Adiposity; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D054304:Anti-Mullerian Hormone / Q000378:metabolism; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D008597:Menstrual Cycle / Q000502:physiology*; D008599:Menstruation Disturbances / Q000209:etiology*; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology*; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000453:epidemiology; D012307:Risk Factors; D018947:Samoa / Q000453:epidemiology; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D013739:Testosterone / Q000097:blood
chemical_list: D052242:Adiponectin; D007328:Insulin; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D054304:Anti-Mullerian Hormone