High prevalence of hirsutism and menstrual disorders in obese adolescent girls and adolescent girls with type 1 diabetes mellitus despite different hormonal profiles

Abstract

Objectives: To compare the pubertal development, the hormonal profiles and the prevalence of hirsutism and menstrual disorders in obese adolescent girls and adolescent girls with type 1 diabetes mellitus (T1DM). Methods: Data were collected from 96 obese adolescent girls and 78 adolescent girls with T1DM at Tanner stage IV or V, whose ages ranged between 11.9 and 17.9 years. Results: High prevalence of hirsutism and menstrual disorder was found in the obese adolescent girls (36.5 and 42% respectively) and the adolescent girls with T1DM (21 and 44% respectively). The obese girls were significantly younger at pubarche, thelarche and menarche than the girls with T1DM. Hirsutism in the obese girls and those with T1DM was associated with hyperandrogenaemia and a raised free androgen index (FAI). When the cause of the raised FAI was investigated in both the groups of girls with hirsutism, the raised FAI in the obese girls was due to low serum sex hormone-binding globulin (SHBG) levels. In contrast, the raised FAI of the girls with T1DM and hirsutism was due to hyperandrogenaemia. Menstrual disorders in the T1DM girls were associated also with hyperandrogenaemia unlike obese girls. Conclusions: Hirsutism and menstrual disorders are common in obese adolescent girls and adolescent girls with T1DM. Although hyperandrogenaemia is present in both groups of girls, the androgenic profiles of the two groups differ. The hyperandrogenaemia in the obese girls is primarily due to their decreased serum SHBG levels, whereas the hyperandrogenaemia in the girls with T1DM is due to their increased androgen production.

Type 1 Diabetes and Polycystic Ovary Syndrome: Systematic Review and Meta-analysis

“…In several studies, the mean hirsutism score was lower in women with type 1 diabetes and PCOS than in their counterparts without diabetes (9,15,31), whereas no differences were found in others (16,26,28). The hormonal profiles of patients with PCOS, with or without type 1 diabetes, were comparable in circulating total testosterone concentrations in most studies (9,15,16,26), yet the cause of the increased free testosterone or free androgen index in patients with PCOS appears to derive from specific mechanisms in women with type 1 diabetes (15).…”

“…Six addressed fertility issues and eighteen addressed menstrual cycle characteristics of type 1 diabetes but were unrelated to androgen excess ( Fig. 1 and Supplementary Data), leaving seventeen original articles dealing with androgen excess (8)(9)(10)(11)(12)(13)(14)(15)(16)(24)(25)(26)(27)(28)(29)(30)(31). Only 9 of these 17 articles contained data about the prevalence of PCOS and related traits (8,(10)(11)(12)(13)(14)(15)(16)28) and were included in the meta-analyses.…”

“…The systematic review identified several articles that compared the PCOS phenotype in women with type 1 diabetes with that of women without diabetes (9,15,26,28,31). In several studies, the mean hirsutism score was lower in women with type 1 diabetes and PCOS than in their counterparts without diabetes (9,15,31), whereas no differences were found in others (16,26,28).…”

Metabolic Syndrome and Infertility in Women

“…Oxidative stress is also postulated to deteriorate fetal development (59). Studies conducted on a female and male animals have demonstrated that uncontrolled diabetes is likely to result in a profound hypogonadotropic state, typified by low basal levels of sex steroids and gonadotropins, defective gonadotropin responses to gonadectomy, and reduced LH pulsatility, resulting in disturbed negative-feedback responses (60).…”

Metabolic syndrome and female reproductive system (review)

“…Окружность талии и уровень инсулина были выше у женщин с нарушениями месячных [39]. В еще одном недавнем исследовании когорты, страдающих ожирением де-вушек-подростков у 42% пациенток имели место менструальные нарушения [40].…”