Diabetic women present an elevated incidence of mestrual disorders often associated with partial gonadotropic insufficiency with reduced LH, E2 and ovarian androgen production. Among our adolescent IDDM population 8 over 36 postmenarcheal girls (22%) complained of oligo- or amenorrhea and 4 of hirsutism also. To verify therir pituitary and ovarian functions we assessed the gonadotropine and ovarian steroid response to the administration of 500 ng s.c. of GnRHa Leuprolide acetate in 7 patients with IDDM (age 17.8±1.7 yrs) and 12 age-matched normal girls. Basal and stimulated LH, FSH, E2, DEAS, 1 and basal 17OHP and 04-A levels were similar in the two groups, regardless of elevated baseline androgens levels in few girls. 24hr-stimulated 17OHP levels were significantly higher in patients than in controls (7.8±2.2 vs. 2.8±0.3 nMol/L, P 0.0001). D4-A responses were also higher than in control although the difference was not statistically significant (9.8±1.4 vs. 6.1±0.7 nMol/L n.s.). This behaviour was similar to that of a previously studied group of 35 adolescents with hirsuitism and ovarian hyperfunction (17OHP 7.0±0.4 nMol/L, D4-A 11.2±0.9 nMol/L). These data demonstrate the presence of a high incidence of ovarian hyperfunction in adolescent diabetic girls which can underline the menstrual disorders. We need a follow-up of these patients to clarify whether they will develop a clear hyperandrogenism, as suggested by our results, or a partial gonadotropin insufficiency as other observed in older diabetic patients.
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Virdis, R., Vanelli, M., Ibanez, L. et al. EVIDENCES OF OVARIAN HYPERFUNCTION IN ADDLESCENT GIRLS WITH INSULIN DEPENDENT DIABETES MELLITUS (IDDM) AND MENSTRUAL DISORDERS. Pediatr Res 33, S20 (1993). https://doi.org/10.1203/00006450-199305001-00102
Archives de Pédiatrie (1995)