Menstrual cycle irregularities and their relationship with HbA1c and insulin dose in adolescents with type 1 diabetes mellitus
Menstrual cycle irregularities and their relationship with HbA1c and insulin dose in adolescents with type 1 diabetes mellitus
复制标题
DOI：
10.1016/j.fertnstert.2009.08.039
复制
发表时间：
2010-10-01
影响因子：
6.7
通讯作者：
Codner, Ethel
中科院分区：
文献类型：
--
作者：
Gaete, Ximena;Vivanco, Maritza;Codner, Ethel
目的：评估1型糖尿病青少年月经周期不规则的患病率和危险因素。设计：月经周期的前瞻性日记。设置：儿科糖尿病诊所和附近的学校。患者：接受每日多次胰岛素剂量治疗的1型糖尿病青少年（n = 56）和56名健康青少年。主要结果测量：月经周期的持续时间和变异性。结果：1型糖尿病女孩和对照组的月经周期持续时间分别为48 +/- 39和32 +/- 7天。与对照组相比，1型糖尿病女孩月经过少（58.9% vs. 19.6%）和闭经（10.7% vs. 1.8%）的发生率更高。在代谢控制最佳的1型糖尿病女孩中，观察到53.3%的月经过少。与对照组相比，HbA 1c水平为7.6%至8.9%的女孩表现出周期持续时间、月经周期变异性和月经过少的患病率增加。回归分析显示，HbA 1c每增加一点，月经周期持续时间就增加5.1天。周期变异性与较高的每日胰岛素dose. Conclusions（S）：尽管最佳的代谢控制，月经过少的患病率较高，观察1型糖尿病女孩与对照组相比。这是第一份报告，以描述高变异性的月经周期在1型糖尿病。HbA 1c和胰岛素剂量是影响1型糖尿病月经不调的重要因素。（Fertil Steril（R）2010;94：1822-6.（C）2010年由美国生殖医学学会。
Objective: To evaluate the prevalence and risk factors of menstrual cycle irregularities in adolescents with type 1 diabetes mellitus.Design: Prospective diary of menstrual cycle.Setting: Pediatric diabetes clinics and nearby schools.Patient(s): Adolescents with type 1 diabetes mellitus treated with multiple daily insulin doses (n = 56) and 56 healthy adolescents.Main Outcome Measure(s): Duration and variability of menstrual cycle.Result(s): Duration of the menstrual cycle was 48 +/- 39 and 32 +/- 7 days in girls with type 1 diabetes mellitus and controls, respectively. Oligomenorrhea (58.9% vs. 19.6%) and amenorrhea (10.7% vs. 1.8%) were more prevalent in girls with type 1 diabetes mellitus than in controls. Oligomenorrhea was observed in 53.3% of the girls with type 1 diabetes mellitus with optimal metabolic control. Girls with an HbA1c level of 7.6% to 8.9% exhibited increased cycle duration, menstrual cycle variability, and prevalence of oligomenorrhea compared with controls. Regression analysis showed that, for each point of increase in HbA1c, the menstrual cycle duration increased by 5.1 days. Cycle variability was associated with a higher daily insulin dose.Conclusion(s): Despite optimal metabolic control, a higher prevalence of oligomenorrhea was observed in girls with type 1 diabetes mellitus compared with controls. This is the first report to describe the high variability of the menstrual cycle in type 1 diabetes mellitus. HbA1c and insulin dose are important factors related to menstrual irregularities in type 1 diabetes mellitus. (Fertil Steril (R) 2010;94:1822-6. (C)2010 by American Society for Reproductive Medicine.)