Polycystic Ovary Syndrome (PCOS) in Juvenile and Adult Type 1 Diabetes in a German/Austrian Cohort.

Abstract

Context While an association between PCOS and type 2 diabetes is well established, to date there have been few data on clinical care of type 1 diabetes (T1D) patients with PCOS. Objective The aim of our study was to characterize T1D patients with the comorbidity of PCOS within the DPV cohort with regard to diabetes phenotype, therapy and metabolic control. Design and Setting Clinical data from the prospective German/Austrian DPV cohort on patients with T1D and documented PCOS (n=76) were compared to female T1D controls (n=32,566) in reproductive age. Results The age at T1D manifestation in PCOS patients was later than in the control group (14.9±8.2 vs. 11.8±7.0 years, p<0.001). PCOS patients had higher BMI-SDS (0.92±0.11 vs. 0.38±0.01, p<0.001), metformin and oral contraceptives were used more frequently (p<0.001). A1c levels were significantly lower (7.92 +/- 0.23% vs. 8.43±0.01%, p<0.05) despite of lower insulin requirements (0.76±0.04 IU/kg/d vs. 0.84±0.00 IU/kg/d, p<0.05). In the PCOS group, higher rates of dyslipidemia (63.4 vs. 48.7%, p =0.032) and thyroid disorders (42.2% vs. 21.2%, p<0.001) were present. Discussion While patients with T1D and comorbid PCOS showed features of a "type 1.5 diabetes" phenotype, insulin requirements per kg body weight were not higher and metabolic control was better, which could be explained only partially by additional metformin therapy. A more precise genetic and metabolic characterisation of these patients is needed to answer open questions on the underlying autoimmune process and residual ß-cell function.

• Authors: Christina Reinauer, Esther Bollow, Elke Fröhlich-Reiterer, Katharina Laubner, Dominik Bergis, Christof Schöfl, Hans-Peter Kempe, Michael Hummel, Pia Hennes, Katja Gollisch, Holger Haberland, Nicolin Datz, Thomas Meissner, Reinhard W Holl
• Journal: Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association (Exp Clin Endocrinol Diabetes) Vol. 125 Issue 10 Pg. 661-668 (Nov 2017) ISSN: 1439-3646 [Electronic] Germany
• PMID: 28926868 (Publication Type: Journal Article, Multicenter Study, Observational Study)
• Copyright: © Georg Thieme Verlag KG Stuttgart · New York.

Topics

• Adolescent
• Adult
• Austria (epidemiology)
• Child
• Cohort Studies
• Comorbidity
• Cross-Sectional Studies
• Diabetes Mellitus, Type 1 (epidemiology)
• Female
• Germany (epidemiology)
• Humans
• Phenotype
• Polycystic Ovary Syndrome (epidemiology)
• Young Adult