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

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

doi:10.1055/s-0043-104701

Experimental and Clinical Endocrinology & Diabetes, Table of Contents

Exp Clin Endocrinol Diabetes 2017; 125(10): 661-668
DOI: 10.1055/s-0043-104701

Article

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

Christina Reinauer

¹Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany

,

Esther Bollow

²Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany

,

Elke Fröhlich-Reiterer

³Department of Paediatrics, Medical University of Graz, Austria

,

Katharina Laubner

⁴Division of Endocrinology and Diabetology, Department of Internal Medicine II, University Hospital of Freiburg, Freiburg, Germany

,

Dominik Bergis

⁵Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany

,

Christof Schöfl

⁶Centres of Endocrinology and Metabolism, Bamberg and Erlangen, Germany

,

Hans-Peter Kempe

⁷Specialized Diabetes Practice Diabetologikum, Ludwigshafen, Germany

,

Michael Hummel

⁸Specialized Diabetes Practice, Rosenheim, Germany

,

Pia Hennes

⁹Department of Pediatrics, Saarland University, Homburg, Germany

,

Katja Gollisch

¹⁰Clinic for Gastroenterology and Gastrointestinal Oncology, Endocrine Unit, University Medical Center Göttingen, Göttingen, Germany

,

Holger Haberland

¹¹Hospital for Children and Adolescents, Sana Hospital Berlin Lichtenberg, Berlin, Germany

,

Nicolin Datz

¹²Diabetes Center for Children and Adolescents, Children's Hospital Auf der Bult, Hannover, Germany

,

Thomas Meissner

¹Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany

,

Reinhard W. Holl

²Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany

› Author Affiliations

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.

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References

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