Hormonal Profile in Women with Polycystic Ovarian Syndrome with or without Type 1 Diabetes Mellitus

CODNER, E.; IÑÍGUEZ, G.; VILLAROEL, C.; LÓPEZ, P.; SOTO, N.; SIR-PETERMANN, T.; CASSORLA, F.; REY, R.

JOURNAL OF CLINICAL ENDOCRINOLOGY AND METABOLISM

Año: 2007 vol. 92 p. 4742 - 4746

0021-972X

Context: Elevated AMH and adrenal androgen levels have been observed during childhood in girls at risk of developing polycystic ovarian syndrome (PCOS). Aim: To evaluate ovarian function and adrenal steroid levels in prepubertal girls with Diabetes mellitus type 1 (DM1).Setting: Academic research institute located within a General Hospital.Design and Patients: We evaluated the hormonal and ultrasonographic characteristics in DM1 girls (N= 68; prepubertal: 15; pubertal: 53) and compared them to a group of healthy (C) girls (N= 86; prepubertal: 24; pubertal: 62) in a cross-sectional study.Results: Prepubertal girls with DM1 had higher AMH (35.9 ± 4.3 vs 23.4 ± 2.0 pmol/l, p<0.01), DHEAS (287.3 ± 80.7 vs. 93.9 ± 17.3 ng/ml, P<0.05), androstenedione (0.5 ± 0.1 vs. 0.2 ± 0.0 ng/ml, P<0.05), and uterine length/ volume (P<0.05) than prepubertal C girls. During puberty, decreasing AMH levels were observed in DM1 girls only (p<0.0001). DM1 Tanner (T) 4-5 girls had lower AMH levels than CT4-T5 (13.3 ± 2.1 vs. 21.1 ± 2.6 pmol/l, respectively, P<0.05). Six prepubertal DM1 girls (40%), but none of the prepubertal control girls had elevated AMH levels (>1.96 standard deviation). Conclusions: Prepubertal girls with DM1 have higher adrenal androgens and AMH than controls. These data suggests that DM1 girls exhibit similar endocrine findings as other groups of girls at risk for developing PCOS. In addition, the effect of DM1 over AMH levels differed in prepubertal and pubertal girls, suggesting that the effect of DM1 over ovarian folliculogenesis changes once gonadotropin levels increase during puberty.