Hormonal profile in women with polycystic ovarian syndrome with or without type 1 diabetes mellitus.
BACKGROUND
Anti-Müllerian hormone (AMH) levels are increased in polycystic ovarian syndrome (PCOS), but it is not known whether other forms of hyperandrogenism, such as PCOS observed in women with type 1 diabetes mellitus (DM1), are also associated with elevated AMH levels.


OBJECTIVE
Our objective was to compare AMH and steroid levels in women with PCOS with and without DM1.


METHODS
We compared the clinical, hormonal, and ultrasonographic characteristics of 17 women with PCOS and DM1 (DM1+PCOS), 20 women with PCOS without DM1 (PCOS), and 35 normal women (control) in a cross-sectional study.


RESULTS
The Ferriman-Gallwey score, serum testosterone, free androgen index, 17OH-progesterone, and ovarian volume were elevated in both groups of PCOS women compared with controls. Serum androstenedione, LH/FSH ratio, and follicle number, however, were higher and SHBG was lower in PCOS compared with DM1+PCOS and controls. AMH levels were higher in PCOS (76.0 +/- 36.3 pmol/liter) than in DM1+PCOS (18.8 +/- 7.4 pmol/liter) and controls (13.9 +/- 8.3 pmol/liter). AMH levels correlated with follicle number in the three groups. Serum AMH/follicle number ratio was higher in PCOS than in DM1+PCOS and controls.


CONCLUSIONS
Women with DM1+PCOS have normal levels of AMH, inhibin B, estradiol, SHBG, and LH/FSH, suggesting that the pathophysiology of hyperandrogenism in PCOS patients with DM1 appears to be different from that in PCOS without DM1. However, hirsutism score and androgen levels were similar in both groups of women with PCOS. We postulate that insulin treatment acts as a co-gonadotropin increasing follicle recruitment, hence not increasing AMH levels.
Codner
Ethel
E
Institute of Maternal and Child Research, School of Medicine, University of Chile, Casilla 226-3, Santiago, Chile. ecodner@med.uchile.cl
Iñíguez
Germán
G
Villarroel
Claudio
C
Lopez
Patricia
P
Soto
Néstor
N
Sir-Petermann
Teresa
T
Cassorla
Fernando
F
Rey
Rodolfo A
RA
D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood; D015992:Body Mass Index; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000000981:diagnostic imaging; D005260:Female; D006062:Gonadotropins / Q000097:blood; D006628:Hirsutism / Q000175:diagnosis / Q000209:etiology; D006728:Hormones / Q000097:blood*; D006801:Humans; D007265:Inhibins / Q000097:blood; D006080:Ovarian Follicle / Q000502:physiology; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000000981:diagnostic imaging; D013256:Steroids / Q000097:blood; D014463:Ultrasonography; D049629:Waist-Hip Ratio
D006062:Gonadotropins; D006728:Hormones; D013256:Steroids; C422364:inhibin B; D007265:Inhibins; D054304:Anti-Mullerian Hormone