MENSTRUAL DISORDERS AND ANDROGEN-RELATED TRAITS IN YOUNG WOMEN WITH TYPE 1 DIABETES MELLITUS: A CLINICAL STUDY

Objective: To investigate possible causes of menstrual disorders and androgen-related traits in young women with type 1 diabetes mellitus (T1DM). Methods: Fifty-three women with T1DM (duration 8.0 +/- 5.6 years), 41 women with (polycystic ovary syndrome) PCOS, and 51 controls matched for age (19.4 +/- 4.3 years vs. 21.2 +/- 2.7 years vs. 20.8 +/- 3.1 years; P>.05) and body mass index (BMI) (22.2 +/- 2.7 kg/m(2) vs. 21.9 +/- 2.0 kg/m(2) vs. 21.4 +/- 1.9 kg/m(2); P>.05) were prospectively recruited. Results: Two women (3.8%) in the T1DM group had not experienced menarche (at 15.5 and 16.6 years); of the rest, 2.3.5% had oligomenorrhea, 32.1% hirsutism, and 45.3% had acne. The age at menarche was delayed in the T1DM group compared to controls (12.7 +/- 1.3 vs. 12.0 +/- 1.0 years; P = .004), while no difference was observed with the polycystic ovary syndrome (PCOS) group (12.4 +/- 1.2 years). There were no differences in total testosterone (0.43 +/- 0.14 ng/mL vs. 039 +/- 0.14 ng/mL; P>.05), dehydroepi- androsterone sulfate (DHEA-S) (269 +/- 112 mu g/dL vs. 238 +/- 106 mu g/dt,; P>.05) or Delta 4-androstenedione (2.4 +/- 1.3 ng/mL vs. 1.9 +/- 0.5 ng/mL; P>.05) concentrations between T1DM and controls. However, patients with T1DM had lower sex hormone binding globulin (SHBG) concentrations than controls (61 +/- 17 nmol/L, vs. 83 +/- 18.1 nmol/L; P = .001), which were even lower in the PCOS group (39.5 +/- 12.9 nmol/L; P = .001 compared with T1DM). The free androgen index (FAI) was higher in the PCOS group compared with both other groups (T1DM vs. PCOS vs. controls: 2.53 +/- 0.54 vs. 7.88 +/- 1.21 vs. 1.6 +/- 0.68; P<.001). FAI was higher in patients with T1DM compared to controls as well (P = .038). There was no difference in DHEA-S concentrations between T1DM and PCOS patients (269 +/- 112 mu g/dt, vs. 297 +/- 100 mu g/dL; P>.05). Conclusion: Menstrual disorders and androgen-related traits in young women with T1DM may be attributed to an increase in androgen bioavailability due to decreased SHBG concentrations.