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1型糖尿病女性与非1型糖尿病女性体内的抗苗勒管激素:糖尿病干预与并发症流行病学研究及密歇根骨健康与代谢研究

Antimüllerian hormone among women with and without type 1 diabetes: the Epidemiology of Diabetes Interventions and Complications Study and the Michigan Bone Health and Metabolism Study.

作者信息

Kim Catherine, Karvonen-Gutierrez Carrie, Kong Shengchun, Arends Valerie, Steffes Michael, McConnell Daniel S, Randolph John F, Harlow Siobán D

机构信息

Department of Medicine, University of Michigan, Ann Arbor, Michigan.

Department of Epidemiology, University of Michigan, Ann Arbor, Michigan.

出版信息

Fertil Steril. 2016 Nov;106(6):1446-1452. doi: 10.1016/j.fertnstert.2016.07.009. Epub 2016 Jul 28.

Abstract

OBJECTIVE

To compare concentrations of antimüllerian hormone (AMH) in women with and without type 1 diabetes.

DESIGN

Cross-sectional analysis of longitudinal studies, adjusting for repeated measures.

SETTING

Not applicable.

PATIENT(S): Women aged 30-45 years who had not undergone oophorectomy, hysterectomy, or natural menopause at the time of AMH measurement were included (n = 376 in the Michigan Bone Health and Metabolism Study and n = 321 in the Epidemiology of Interventions and Complications Study). Linear mixed regression was used to evaluate whether AMH concentrations differed by diabetes status, adjusting for repeated measurements of AMH within individual women, body mass index, smoking status, and oral contraceptive use.

INTERVENTION(S): None.

MAIN OUTCOME MEASURE(S): Concentrations of AMH.

RESULT(S): In unadjusted comparisons, women with and without diabetes had similar median AMH values before 35 years of age, although women with type 1 diabetes had a lower proportion of women with elevated AMH concentrations (≥5.0 ng/dL). After adjustment for covariates and multiple observations per woman, log AMH concentrations were significantly lower among women with type 1 diabetes compared with women without diabetes (β-coefficient -1.27, 95% confidence interval [-2.18, -0.36] in fully adjusted models) before 35 years of age.

CONCLUSION(S): Before 35 years of age, women with type 1 diabetes have lower AMH levels than women without diabetes. Further investigation is needed to determine the etiologies of this difference and how it may contribute to reproductive disorders among women with type 1 diabetes.

摘要

目的

比较1型糖尿病女性与非1型糖尿病女性体内抗苗勒管激素(AMH)的浓度。

设计

对纵向研究进行横断面分析,并对重复测量数据进行校正。

设置

不适用。

患者

纳入年龄在30至45岁之间、在测量AMH时未接受过卵巢切除术、子宫切除术或自然绝经的女性(密歇根骨健康与代谢研究中有376例,干预与并发症流行病学研究中有321例)。采用线性混合回归评估AMH浓度是否因糖尿病状态而异,并对个体女性AMH的重复测量值、体重指数、吸烟状况和口服避孕药使用情况进行校正。

干预措施

无。

主要观察指标

AMH浓度。

结果

在未经校正的比较中,35岁之前,1型糖尿病女性与非糖尿病女性的AMH中位数相似,尽管1型糖尿病女性中AMH浓度升高(≥5.0 ng/dL)的女性比例较低。在对协变量和每位女性的多次观察进行校正后,35岁之前,1型糖尿病女性的对数AMH浓度显著低于非糖尿病女性(完全校正模型中的β系数为-1.27,95%置信区间为[-2.18, -0.36])。

结论

35岁之前,1型糖尿病女性的AMH水平低于非糖尿病女性。需要进一步研究以确定这种差异的病因以及它如何导致1型糖尿病女性的生殖障碍。

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