Age of Menarche and PCOS in Type 1 Diabetes

Agnieszka Łebkowska, Agnieszka Adamska, Anna Krentowska, Aleksandra Uruska, Anita Rogowicz-Frontczak, Aleksandra Araszkiewicz, Katarzyna Ożegowska, Justyna Hryniewicka, Monika Leśniewska, Ewa Wender-Ożegowska, Dorota Zozulińska-Ziółkiewicz, Irina Kowalska
The Journal of Clinical Endocrinology & Metabolism, Volume 106, Issue 6, June 2021, Pages 1811–1820
https://doi.org/10.1210/clinem/dgab062

Abstract

Context

Higher prevalence of polycystic ovary syndrome (PCOS) in women with type 1 diabetes (T1DM) is linked to exogenous insulin, especially when diabetes is diagnosed before puberty.

Objective

The study evaluates the impact of prepubertal onset of T1DM and insulin therapy on PCOS diagnosis and phenotypic characteristics in women with T1DM.

Design, Setting, and Patients

We studied 83 women with T1DM (age 26 ± 5 years, BMI 24 ± 3 kg/m²) 36 with premenarchal (PM) onset of T1DM [17 with PCOS diagnosed (PCOS+PM) and 19 without PCOS (noPCOS+PM)] and 47 women with postmenarchal onset of T1DM [24 with PCOS (PCOS-noPM) and 23 without PCOS (noPCOS-noPM)].

Outcome Measurements

Clinical examination, assessment of serum sex hormones, glycated hemoglobin (HbA1c) and ultrasonographic evaluation of the ovaries were performed in all women.

Results

Applying Rotterdam criteria, 49% of women with T1DM were diagnosed with PCOS. There were no differences in hormonal profile and ovarian parameters between PCOS+PM and PCOS-noPM. Women with T1DM+PM had higher insulin dose/24 h and U/kg bw/24 h than T1DM-noPM (P-values = 0.014 and 0.001, respectively). Both PCOS+PM and noPCOS+PM groups had higher insulin dose U/kg bw/24 h in comparison to PCOS-noPM (P-values = 0.004 and = 0.006, respectively). In multivariable logistic regression analysis, age of menarche [odds ratio (OR): 0.672; 95% confidence interval (CI): 0.465-0.971] and HbA1c (OR: 0.569; 95% CI: 0.383-0.846) were associated with the diagnosis of PCOS.

Conclusions

There were no differences in the prevalence of PCOS between T1DM+PM and T1DM-noPM; however, earlier menarche might have an influence on PCOS diagnosis in women with T1DM.

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