The effect of residual beta cell activity on menstruation and the reproductive hormone profile of insulin-dependent diabetics.
To investigate the cause of secondary amenorrhoea in insulin-dependent diabetes gonadotrophins, sex steroid hormone levels and residual beta cell activity (C-peptide index) were estimated in a group of 43 women with IDDM. Among 26 women with residual insulin secretion, the C-peptide positive (CpP) group, 5 had secondary amenorrhoea (CpP-Am); among 17 women without endogenous beta cell activity, the C-peptide negative (CpN) group 6 had secondary amenorrhoea (CpN-Am). In this study two different types of secondary amenorrhoea in insulin-dependent diabetics were observed. All CpP-Am women have the classical hormone profile of the polycystic ovary syndrome (increased (LH/FSH ratio, increased serum testosterone, decreased SHBG) together with a history of oligomenorrhoea and excess weight before the onset of diabetes. On the other hand, all CpN-Am women had decreased LH levels as well as low LH/FSH ratio and testosterone levels. These results strongly suggest that a lack of residual pancreatic beta cell activity influences hypothalamus-pituitary function in insulin-dependent diabetes. It might be concluded that PCOS is independent of diabetes while low LH amenorrhoea seems to be the consequence of diabetes and is strongly associated with a lack of residual insulin secretion.
Prelević
G M
GM
Endocrinology Department, Medical Centre Zvezdara, Belgrade University School of Medicine, Yugoslavia.
Würzburger
M I
MI
Perić
L A
LA
D000568:Amenorrhea / Q000097:blood*; D002096:C-Peptide / Q000097:blood*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood*; D006065:Gonadotropins, Pituitary / Q000097:blood*; D006801:Humans; D007328:Insulin / Q000378:metabolism; D000078790:Insulin Secretion; D007515:Islets of Langerhans / Q000503:physiopathology*; D008598:Menstruation; D011388:Prolactin / Q000097:blood; D011863:Radioimmunoassay; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D014463:Ultrasonography
D002096:C-Peptide; D012739:Gonadal Steroid Hormones; D006065:Gonadotropins, Pituitary; D007328:Insulin; D012738:Sex Hormone-Binding Globulin; D011388:Prolactin