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Ovarian function during puberty in girls with type 1 diabetes mellitus: Response to Leuprolide

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2005-07
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Codner Dujovne, Ethel
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Ovarian function during puberty in girls with type 1 diabetes mellitus: Response to Leuprolide
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Author
  • Codner Dujovne, Ethel;
  • Mook-Kanamori, Dennis;
  • Bazaes Castillo, Rodrigo Antonio;
  • Unanue Morales, Nancy;
  • Sovino, Hugo;
  • Ugarte, Francisca;
  • Avila, Alejandra;
  • Iñíguez Vila, Germán;
  • Cassorla Goluboff, Fernando;
Abstract
Context: An increased prevalence of polycystic ovary syndrome (PCOS) has been reported in adult women with type 1 diabetes mellitus (DM1). We investigated whether these hormonal abnormalities begin during puberty by evaluating the ovarian steroidogenic response to leuprolide acetate. Methods: We studied 56 adolescent girls with DM1 (aged 12.3 +/- 0.2 yr) and 64 healthy girls (C) (aged 11.9 +/- 0.2 yr) up to 2 yr post menarche, matched by age, body mass index, and pubertal development. We evaluated anthropometrical data and Ferriman-Gallway score and performed a leuprolide test (500 mu g sc) to study ovarian function. Ovarian volume was determined by transabdominal ultrasonography. Results: We found five DM1 but no C girls with abnormally located terminal hair (Fisher's exact, P < 0.05). Free androgen index increased throughout puberty in girls with DM1 (ANOVA, P < 0.0001), which was associated with a decrease in SHBG levels in girls with DM1 (ANOVA, P < 0.0001). Stimulated 17OH progesterone (17OHProg) increased throughout puberty only in girls with DM1 (ANOVA, P < 0.01). Girls with DM1 at Tanner stage 5 had higher stimulated LH to FSH ratio, testosterone, and 17OHProg levels than girls at Tanner stage 4. In contrast, in C girls the stimulated testosterone, 17OHProg, and LH to FSH ratio were similar at Tanner stages 4 and 5. Ovarian volumes and uterine length were larger in girls with DM1 (analysis of covariance, P < 0.05). Conclusions: These data suggest that patients with DM1 have differences in ovarian steroidogenic response to leuprolide, compared with C girls during puberty. Future studies in young women should clarify whether these findings are related to the pathogenesis of hyperandrogenism later in life.
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URI: https://repositorio.uchile.cl/handle/2250/127162
ISSN: 0021-972X
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JOURNAL OF CLINICAL ENDOCRINOLOGY AND METABOLISM 90 (7): 3939-3945 JUL 2005
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