Menstrual Dysfunction in Girls from the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) Study.

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Menstrual Dysfunction in Girls from the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) Study.

J Clin Endocrinol Metab. 2018 Apr 24;:

Authors: Kelsey MM, Braffett BH, Geffner ME, Levitsky LL, Caprio S, McKay SV, Shah R, Sprague JE, Arslanian SA, TODAY Study Group

Abstract
Context: Little is known about reproductive function in girls with youth-onset type 2 diabetes.
Objectives: To characterize girls with irregular menses, and effects of glycemic treatments on menses and sex steroids in the Treatment Options for Type 2 Diabetes in Youth (TODAY) study.
Design: Differences in demographic, metabolic, and hormonal characteristics between regular vs. irregular menses groups were tested; treatment group (metformin +/- rosiglitazone, metformin + lifestyle) effect on menses and sex steroids over time in the study was assessed. This is a secondary analysis of TODAY data.
Setting: Multi-center study in an academic setting.
Patients: TODAY girls not on hormonal contraception and those > 1-year post-menarche were included. Irregular menses was defined as < 3 periods in the prior 6 months.
Results: Eligible participants with serum measurement of sex steroids (n=190, mean age 14 years), 21% had irregular menses. Those with irregular vs. regular menses had higher body mass index (BMI) (p=0.001), AST (p=0.001), free androgen index (p=0.0003), total testosterone (p=0.01); and lower sex-hormone binding globulin (SHBG) (p=0.004) and estradiol (p=0.01). Differences remained after adjusting for BMI. There was no treatment group effect on menses or sex steroids at 12 or 24 months, and no association of sex steroids with measures of insulin sensitivity or secretion.
Conclusions: Menstrual dysfunction is common in girls with recently diagnosed T2D and associated with alterations in sex steroids, SHBG, and AST, but not with alteration in insulin sensitivity or β-cell function, and did not improve with 2 years of anti-hyperglycemic treatment.

PMID: 29697830 [PubMed - as supplied by publisher]

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