Reproductive history and hormonal birth control use are associated with coronary calcium progression in women with type 1 diabetes mellitus.
BACKGROUND
Coronary artery disease is increased in women with type 1 diabetes (T1D), compared with nondiabetic (Non-DM) women. Women with T1D have more menstrual dysfunction and are less likely to use hormonal birth control (BC) than Non-DM women.


OBJECTIVE
The purpose of this study was to determine whether coronary artery calcium (CAC) is associated with menstrual dysfunction and BC use in women with T1D.


METHODS
This was a prospective cohort study, and participants were followed up for an average of 2.4 yr.


METHODS
Patients included 612 women (293 T1D, 319 Non-DM) between the ages of 19 and 55 yr who had CAC measured twice by electron beam tomography.


RESULTS
Irregular menses and amenorrhea were more common in T1D than Non-DM women (22.1 vs. 14.9%, P < 0.05 and 16.6 vs. 7.0%, P < 0.001). T1D women reported less BC use than Non-DM women (79.8 vs. 89.9%, P < 0.001) and reached menarche at an older age (13.1 +/- 1.8 vs. 12.8 +/- 1.5 yr, P < 0.05). Use of BC was associated with less CAC progression in all women, but this association was stronger in T1D women (P value for interaction = 0.02). Irregular menses were associated with greater CAC progression only among T1D women.


CONCLUSIONS
A prior history of BC use is associated with reduced CAC progression among all women, with a stronger association in T1D than in Non-DM women. Women with T1D who report irregular menses have increased CAC progression, compared with those with regular menses.
Snell-Bergeon
Janet K
JK
Barbara Davis Center for Childhood Diabetes, University of Colorado at Denver and Health Sciences Center, Aurora, CO 80045, USA. janet.snell-bergeon@uchsc.edu
Dabelea
Dana
D
Ogden
Lorraine G
LG
Hokanson
John E
JE
Kinney
Gregory L
GL
Ehrlich
James
J
Rewers
Marian
M
D000328:Adult; D002114:Calcinosis / Q000209:etiology*; D002118:Calcium / Q000378:metabolism; D015331:Cohort Studies; D003267:Contraception / Q000009:adverse effects*; D003271:Contraceptive Agents, Female / Q000009:adverse effects / Q000627:therapeutic use; D003324:Coronary Artery Disease / Q000209:etiology*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008875:Middle Aged; D017584:Reproductive History; D012307:Risk Factors; D013997:Time Factors
D003271:Contraceptive Agents, Female; D002118:Calcium