Lina Saleh Hassan1, Rebecca S Monson2, Kirstie K Danielson1,2. 1. Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, IL, USA. 2. Division of Transplant Surgery, University of Illinois at Chicago, Chicago, IL, USA.
Abstract
BACKGROUND: This study aimed to investigate whether oestradiol differs between premenopausal women with and without type 1 diabetes and whether levels are associated with such factors as age, reproductive history or diabetes management. METHODS: Oestradiol in premenopausal women with type 1 diabetes (n = 89; age = 18-50 years; duration = 13-18 years) and age-matched/race-matched controls without diabetes (n = 76) was collected during a cross-sectional ancillary study of the Wisconsin Diabetes Registry Study, a population-based incident cohort. Total and bioavailable oestradiol and sex hormone-binding globulin were compared using multivariable regression (e.g. adjusting for reproductive history). RESULTS: Adjusted mean total and bioavailable oestradiol did not differ overall by diabetes status (p ≥ 0.74), while adjusted mean sex hormone-binding globulin was higher in type 1 diabetes women (p = 0.02). However, only in women with type 1 diabetes and not controls (interaction p = 0.0005) was total oestradiol positively associated with the duration of reproductive years with unsuppressed ovarian function (UnsuppOvFx = years since menarche minus years on hormonal contraceptives/pregnant/breastfeeding). When stratified into less than/equal to or greater than the median 9 years' duration of UnsuppOvFx, compared with controls, women with type 1 diabetes had significantly lower total oestradiol in the ≤9 years group [β = -43.2 pg mL-1 (-158.6 pmol L-1 ), p = 0.04] and significantly higher total oestradiol in the >9 years group [β = 53.9 pg mL-1 (197.9 pmol L-1 ), p = 0.04]. Results remained consistent during additional statistical adjustments and sensitivity analyses. CONCLUSIONS: Compared with controls, women with type 1 diabetes may have lower oestradiol when they have a shorter duration of UnsuppOvFx and higher oestradiol when they have a longer duration of UnsuppOvFx. Given the potential effects of insulin on ovarian function, oestradiol production may vary across the lifespan for women with type 1 diabetes.
BACKGROUND: This study aimed to investigate whether oestradiol differs between premenopausal women with and without type 1 diabetes and whether levels are associated with such factors as age, reproductive history or diabetes management. METHODS:Oestradiol in premenopausal women with type 1 diabetes (n = 89; age = 18-50 years; duration = 13-18 years) and age-matched/race-matched controls without diabetes (n = 76) was collected during a cross-sectional ancillary study of the Wisconsin Diabetes Registry Study, a population-based incident cohort. Total and bioavailable oestradiol and sex hormone-binding globulin were compared using multivariable regression (e.g. adjusting for reproductive history). RESULTS: Adjusted mean total and bioavailable oestradiol did not differ overall by diabetes status (p ≥ 0.74), while adjusted mean sex hormone-binding globulin was higher in type 1 diabeteswomen (p = 0.02). However, only in women with type 1 diabetes and not controls (interaction p = 0.0005) was total oestradiol positively associated with the duration of reproductive years with unsuppressed ovarian function (UnsuppOvFx = years since menarche minus years on hormonal contraceptives/pregnant/breastfeeding). When stratified into less than/equal to or greater than the median 9 years' duration of UnsuppOvFx, compared with controls, women with type 1 diabetes had significantly lower total oestradiol in the ≤9 years group [β = -43.2 pg mL-1 (-158.6 pmol L-1 ), p = 0.04] and significantly higher total oestradiol in the >9 years group [β = 53.9 pg mL-1 (197.9 pmol L-1 ), p = 0.04]. Results remained consistent during additional statistical adjustments and sensitivity analyses. CONCLUSIONS: Compared with controls, women with type 1 diabetes may have lower oestradiol when they have a shorter duration of UnsuppOvFx and higher oestradiol when they have a longer duration of UnsuppOvFx. Given the potential effects of insulin on ovarian function, oestradiol production may vary across the lifespan for women with type 1 diabetes.
Authors: J F Sallis; W L Haskell; P D Wood; S P Fortmann; T Rogers; S N Blair; R S Paffenbarger Journal: Am J Epidemiol Date: 1985-01 Impact factor: 4.897
Authors: K S Polonsky; B D Given; L Hirsch; E T Shapiro; H Tillil; C Beebe; J A Galloway; B H Frank; T Karrison; E Van Cauter Journal: J Clin Invest Date: 1988-02 Impact factor: 14.808