Menstrual Cycle in Girls and Young Women with Insuln Dependent Diabetes Mellitus
Ňajderová, Martínek, Hořejší, Nováková, Koloušková, Vavřinec, Šumník, Lánská, Cinek
2. dětská klinika, 2. LF UK a FN Motol, Praha, přednosta doc. MUDr. J. Vavřinec CSc., Ústav pro histologii a embryologii 1. LF UK, Praha, přednosta doc. MUDr. P. Hach, CSc., Gynekologicko-porodnická klinika 2. LF UK a FN Motol, Praha, přednosta prof. MUDr. J. Hořejší, DrSc, Oddělení buněčné a molekulární imunologie CBO, 3. LF UK, Praha, přednosta doc. MUDr. M. Jíra, CSc, Oddělení statistiky, IKEM Praha, ředitel MUDr. Karel Filip, CSc. |
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Summary:
Objective: Menstrual cycle disorders are known to occur more frequently in patients with insulin
dependent diabetes mellitus (IDDM) than in general non-diabetic population. Potential risk factors were analysed.
Design: An open prospective clinical study.
Methods: The cohort of 96 postmenarchal IDDM patients aged 17.8 (12-27) yr. (mean, range),
menarche at 13.4 (10-14.6) yr., with IDDM onset at 9.6 (0.8-17.5) yr. and duration of IDDM 8.4
(0.1-26.2) yr. was followed up. Relation of menstrual cycle characteristics to metabolic control
(HbA1C), body mass index (BMI), age at IDDM onset, duration of IDDM and to autoimmune thyroi-
ditis was studied.
Results: Menstrual cycle disorders were more frequent in IDDM patients (29/96, 30.2%), than in the
general non-diabetic population (11-18%, p < 0.01). Secondary ammenorrhea (in 4 patients) was
associated with poor IDDM control, as the level of HbA1C was significantly higher 12.6 (11.8-13.1)%
than in 92 girls without ammenorrhea, 10.0 (6.1-14%) (p < 0.01). On the contrary, the effect of
metabolic control or BMI was not present in 7 patients with oligomenorrhea, or in 18 patients
with irregular cycle. Autoimmune thyroiditis was more frequent in patients with cycle disturbances (8/29, 27.6%), compared with those with regular cycles (8/67, 11.9%, p < 0.05). Early IDDM onset
(before the age of 10) increased risk of delayed menarche (after the age of 15).
Conclusions: Higher frequency of menstrual cycle disturbances in IDDM patients was confirmed.
Poor metabolic control was a risk factor of secondary amenorrhea. Menstrual cycle disturbances
were more frequent in patients with autoimmune thyroid disease.
Key words:
insulin dependent diabetes mellitus, IDDM, menstrual cycle, disturbances
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