Background: The mechanisms underlying dyslipidaemia in the context of polycystic ovary syndrome may include not only metabolic aberrations but also hormonal factors, in particular hyperandrogenaemia.
Objective and hypotheses: The aim of the study was to establish whether dyslipidaemia and metabolic control disturbances are related to hyperandrogenaemia in adolescent girls with type 1 diabetes mellitus (T1DM).
Method: We studied 54 girls with T1DM in the chronological age 15.9±1.3 years and gynecological age 33.7±16.7 months. 28 of them had normal androgen plasma levels and in 16 hyperandrogenaemia was found. Fourteen healthy, regularly menstruating girls without hyperandrogenaemia (chronological age 16.1±1.2 years; gynecological age 48.9±14.9 months) served as control group (CG). In all girls levels of lipids and hormones were measured. In each diabetic subject HbA1c records from the beginning of T1DM and daily insulin requirement (DIR) for last 3 days were obtained.
Results: Total cholesterol was significantly higher in diabetic girls with hyperandrogenaemia than in CG (196.1±41.2 vs 162.2±32.8 mg/dl, P=0.01). Also LDL-cholesterol was the highest in girls with T1DM and elevated androgen level (117.3±33.1 mg/dl) and significantly higher than in diabetic girls without hyperandrogenaemia (97.7±26.7 mg/dl, P=0.03) and in CG (90.9±28.8 mg/dl, P=0.02). There were no significant differences between the studied groups with respect to triglycerides. There was no significant relationship between BMI Z-score and lipids concentration in diabetic group. We did not find any significant differences in mean HbA1c from the beginning of T1DM and for the last year as well as in DIR and type of insulin therapy (intensive vs continuous) between the groups. In diabetic group significant correlations between LDL-cholesterol and hyperandrogenaemia (rgamma=0.4, P=0.01) and free androgen index (FAI) (r=0.4, P=0.01) were found. In multivariate logistic regression analysis the association between LDL-cholesterol and FAI did not change significantly after adjusted for BMI Z-score.
Conclusion: It is concluded that hyperandrogenaemia may contribute to dylipidaemia in adolescent girls with T1DM.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology