Aim of the study: Assessment of the incidence of ovarian functional disorders correlated with thyroid disorders appreciated clinically, functional, and echostructural in a group of diabetic female teenagers according to 25-(OH)- vitamin D serum levels.
Method: A group of 31 patients with diabetes mellitus and vitamin D deficiency (mean age 16.3 ± 1.3) was studied compared to a control group (43 teenagers) with diabetes and a normal vitamin D level, (mean age 16.7 ± 0.8). In all cases, diabetes mellitus was diagnosed and treated from the prepubertal period.
We evaluated the characteristics of the ovarian cycle, the development of sexual characteristics, serum levels of ovarian and gonadotrophic hormones, thyroid changes as measured by clinical and ultrasound examination as well as the measurement of free- thyroxine (FT4), thyrotropin (TSH) and serum 25-(OH)-vitamin D.
Results: Menstrual disorders occurred in 77.4% of adolescents with diabetes and low vitamin D, compared with 24.4% among adolescents in the control group. Changes in serum levels of ovarian hormones were significantly more common among patients with diabetes mellitus and vitamin D deficiency (77.4%) than the control group (31.3%). Ovarian hormonal changes were the progesterone deficiency (83% / 68%) and hyperprolactinemia (23% / 9.3%). The incidence of goiter (26.3% / 11.8%) and thyroid volume (14.3ml / 9.8ml) were higher among the patients with diabetes and low vitamin D. Thyroid functional disorders were recorded in 4 teenagers in the study group: 3 cases with subclinical hypothyroidism and 1 case with overt hypothyroidism. The positivity of anti-thyroid autoantibodies was present in 29% of teenagers with low vitamin D versus 2.4% of teenagers in the control group. The study was conducted in the perimarine area of Romania known to have a maximum annual sunny period compared to the rest of the country.
Conclusions: Vitamin D deficiency associated with insulin dependent diabetes mellitus in puberty appears to be a factor with an aggravating role in the development of ovarian and thyroid disorders appreciated clinically, echostructural and functional.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology