Codner Ethel, Soto Nestor, Lopez Patricia, Trejo León, Avila Alejandra, Eyzaguirre Francisca C, Iniguez Germán, Cassorla Fernando
Institute of Maternal and Child Research, School of Medicine, University of Chile, Casilla 226-3, Santiago, Chile.
J Clin Endocrinol Metab. 2006 Jun;91(6):2250-6. doi: 10.1210/jc.2006-0108. Epub 2006 Mar 28.
The criteria for diagnosis of polycystic ovary syndrome (PCOS) have been modified and now include polycystic ovary morphology (PCOM).
The purpose of this study was to determine the frequency of PCOS and PCOM in women with type 1 diabetes mellitus (DM1).
We evaluated the clinical, hormonal, and ultrasonographic characteristics in women with DM1 and compared them with a carefully matched group of normal women in a cross-sectional study.
The study was conducted at an academic research institute located within a general hospital.
All the women with DM1 attending our hospital who had experienced menarche at least 2.5 yr earlier were invited to participate and were compared with healthy women with regular menses and without a history of hyperandrogenism [controls (C)].
Hirsutism was present in 28.6 and 0.0% of DM1 and C, respectively (P < 0.001). Biochemical hyperandrogenism was present in 23.8 and 7.9% of DM1 and C, respectively. DM1 women had higher levels of testosterone and androstenedione and larger ovarian volume and follicle number by ovary than C. PCOM was present in 54.8% of DM1 and 13.2% of C (P < 0.001). Oligomenorrhea was present in 19% of women with DM1. The frequency of PCOS was 40.5 and 2.6% in DM1 and C, respectively (relative risk, 15.4; 95% confidence interval, 2.2-110.2; P < 0.0001). The proportion of women using intensive insulin treatment was higher in those with PCOM/PCOS (P < 0.05). Intensive treatment was a significant factor over having PCOM/PCOS (P < 0.05).
A high frequency of hyperandrogenism, PCOM, and PCOS is observed in DM1, which appears to be associated with intensive insulin treatment.
多囊卵巢综合征（PCOS）的诊断标准已被修订，现在包括多囊卵巢形态（PCOM）。
本研究的目的是确定1型糖尿病（DM1）女性中PCOS和PCOM的发生率。
在一项横断面研究中，我们评估了DM1女性的临床、激素和超声特征，并将其与精心匹配的正常女性组进行比较。
该研究在一家综合医院内的学术研究机构进行。
邀请我院所有初潮至少2.5年前的DM1女性参与研究，并与月经规律且无高雄激素血症病史的健康女性[对照组（C）]进行比较。
多毛症在DM1组和C组中的发生率分别为28.6%和0.0%（P<0.001）。生化高雄激素血症在DM1组和C组中的发生率分别为23.8%和7.9%。DM1女性的睾酮和雄烯二酮水平更高，卵巢体积更大，卵巢卵泡数量比C组多。PCOM在DM1组中的发生率为54.8%，在C组中的发生率为13.2%（P<0.001）。DM1女性中19%有月经过少。PCOS在DM1组和C组中的发生率分别为40.5%和2.6%（相对风险，15.4；95%置信区间，2.2-110.2；P<0.0001）。使用强化胰岛素治疗的女性在PCOM/PCOS患者中所占比例更高（P<0.05）。强化治疗是比患有PCOM/PCOS更重要的因素（P<0.05）。
在DM1中观察到高雄激素血症、PCOM和PCOS的高发生率，这似乎与强化胰岛素治疗有关。
