Endocrine Abstracts

JOINT213

Background: Menstrual irregularities and polycystic ovary syndrome (PCOs) are recognized morbidities among women with type 1 diabetes mellitus (T1DM) representing significant physical and psychological burden. Identifying the risk determinants of these morbidities and providing therapeutic interventions for them is of utmost importance.

Objectives: assess the frequency of PCOs among adolescent females with T1DM and correlate it with serum leptin, abdominal adiposity, insulin resistance, glycemic and lipid metrics.

Methods: Hundred-seventy five adolescent females with T1DM were assessed for diabetes duration, insulin therapy, menstrual regularity, manifestations of insulin resistance, hirsutism, anthropometric measures, systolic and diastolic blood pressure percentiles. Serum leptin, glycated-hemoglobin (HbA1c), fasting blood glucose and lipids, basal and stimulated follicle stimulating hormone (FSH) and luteinizing hormone (LH) were measured with calculation of the LH/FSH ratio and estimated glucose disposal rate (eGDR). Trans-abdominal pelvic ultrasound was done with measurement of the right and left ovarian size and endometrial thickness. Rotterdam criteria were adopted to diagnose PCOs.

Results: Sixty four adolescent females with T1DM had PCOs (36.6%). Adolescent females with T1DM having PCOs had significantly higher diabetes duration, total daily insulin dose, abdominal adiposity (waist/hip ratio z score), insulin resistance, serum leptin, LH/FSH ratio and low density lipoproteins (LDL) than those without (P < 0.05). Multivariate-logistic regression analysis showed that diabetes duration (p-value= 0.030), waist/hip ratio (p-value= 0.030), LDL (p-value= 0.034), eGDR (P = 0.008), serum leptin (p-value= 0.009), and right ovarian volume (P = 0.008) were the most significant independent factors associated with PCOs among this vulnerable cohort.

Conclusion: PCOs is a prevalent morbidity among adolescent females with T1DM being associated with abdominal adiposity, insulin resistance, and hyperleptinemia.

Keywords: Adolescent females; Type 1 diabetes; Polycystic ovary; Leptin, Glycemic control.