Ovarian morphology and prevalence of polycystic ovary syndrome in Japanese women with type 1 diabetes mellitus

Abstract

Aims/Introduction: Polycystic ovary syndrome (PCOS) is a heterogeneous disorder including polycystic ovary morphology (PCOM), ovulatory dysfunction and hyperandrogenism. PCOS is frequently associated with type 2 diabetes mellitus; however, it is unknown whether PCOM and PCOS are prevalent in Japanese patients with type 1 diabetes mellitus. The purpose of our study was to determine the frequency of PCOM and PCOS in women with type 1 diabetes mellitus. Materials and Methods: We evaluated clinical, hormonal and ovarian ultrasound data from 21 type 1 diabetes mellitus patients whose average glycated hemoglobin levels were 7.9 -1.5%. Results: Ultrasound identified PCOM in 11 patients (52.4%) and these patients also had higher levels of the androgen dehydroepiandrosterone sulfate (DHEA-S) than those without PCOM (P < 0.05). Of the patients with PCOM, five presented menstrual irregularities (45.5%) and three met the Japanese criteria for PCOS (27.2%); whereas all patients without PCOM had a normal menstrual cycle (P < 0.05). Conclusions: Japanese premenopausal women with type 1 diabetes mellitus had a high frequency of PCOM as well as PCOS. This is the first research of this area carried out in an Asian population. (J Diabetes Invest

Type 1 Diabetes and Polycystic Ovary Syndrome: Systematic Review and Meta-analysis

“…This was also supported by the finding of androgenized ovarian responses to the gonadotropinreleasing hormone analog leuprolide in these women, consisting of increased circulating 17-hydroxyprogesterone concentrations (24,25). However, as happens in women without diabetes, the adrenal glands may also contribute to androgen excess in women with PCOS and type 1 diabetes, explaining the mildly increased dehydroepiandrosterone sulfate levels found in some series (14,28).…”

“…Of note, even though this association was confirmed by all of the studies that addressed the issue thereafter (10)(11)(12)(13)(14)(15)(16), with prevalences of PCOS as high as 40% in some series (10,16), this syndrome is seldom diagnosed and treated in women with type 1 diabetes.…”

“…Therefore, the possibility exists that differences in the treatment of type 1 diabetes, such as glycemic control, daily insulin dose, and method of insulin administration, influence the association between both disorders. Glycemic control and daily insulin doses at recruitment were similar in patients with type 1 diabetes presenting with or without PCOS or hyperandrogenic traits in most series (8,10,(14)(15)(16)28), and only in one study was the insulin dose higher in patients with type 1 diabetes with PCOS (11). Another study reported slightly higher mean HbA 1c levels since diagnosis of type 1 diabetes in the patients presenting with PCOS and an association between androgen concentrations and mean HbA 1c and type 1 diabetes duration in adolescents with poor metabolic control (15).…”

“…Six addressed fertility issues and eighteen addressed menstrual cycle characteristics of type 1 diabetes but were unrelated to androgen excess ( Fig. 1 and Supplementary Data), leaving seventeen original articles dealing with androgen excess (8)(9)(10)(11)(12)(13)(14)(15)(16)(24)(25)(26)(27)(28)(29)(30)(31). Only 9 of these 17 articles contained data about the prevalence of PCOS and related traits (8,(10)(11)(12)(13)(14)(15)(16)28) and were included in the meta-analyses.…”

A case of lean polycystic ovary syndrome with early stage of type 1 diabetes successfully treated with metformin [Rapid Communication]

“…The prevalence of PCOS in Japanese women with type 1 diabetes is reported as 27.2% in a previous report [3]. Therefore, PCOS could be caused by hyperinsulinemia in both insulin resistant type 2 diabetes and insulin treated type 1 diabetes, and the onset of hyperandrogenism is often later than that of diabetes [2].…”