Endocrine Abstracts

Background: Type 1 DM has been shown to be associated with increased rate of hyperandrogenemia, polycystic ovarian changes (PCO) and PCOS. Although stimulated 17-OH progesterone responses to leuprolide has previously been shown to be increased in pubertal girls with type 1 DM, the effect of gonadotropin releasing hormone analog stimulation has not been studied in adult women.

Materials and methods: Fifty-two adult women with type 1 DM and 15 healthy adult women were included in the study. Participants were evaluated with basal total and free testosterone, androstenedione, DHEAS, FSH, LH, estradiol, PRL and TSH levels. Buserelin test was performed to all participants and FSH, LH, estradiol and 17-OH progesterone responses were measured six hourly intervals for 24 hours. Patients were evaluated in means of menstrual function, ovulation, clinical or laboratory hyperandrogenism and PCO on ovarian USG.

Results: The mean age and body mass index (BMI) of the patients and the control group were similar. Patients with type 1 DM had higher free testosterone and 17-OH progesterone levels. Basal and stimulated FSH and LH responses to buserelin were found to be similar in both groups, but although non-significant, estradiol and 17-OH progesterone responses were found to be mildly elevated in patients with type 1 DM compared to control. PCOS was detected in 34.6%, hyperandrogenemia in 44.2%, clinical findings of hyperandrogenism in 28.8%, PCO on USG in 24.5% and menstrual irregularity in 36.6% of the patients. BMI, diabetes duration, daily requirement of insulin and HbA1C did not show statistically significant differences in subgroups of type 1 DM patients with or without PCOS.

Conclusion: Type 1 DM is associated with increased basal free testosterone and 17-OH progesterone levels. FSH and LH responses to buserelin is preserved, but estradiol and 17-OH progesterone responses to buserelin are mildly increased in women with type 1 DM.