Pubertal development and gonadotrophic hormones among girls with type 1 diabetes mellitus

Abstract EN

Background: As a chronic disease occurring in childhood, type 1 diabetes is a factor potentially affecting the pubertal development, including age at menarche.

Aim of study: To investigate the effect of type 1 diabetes on pubertal development among adolescents; and to investigate their gonadotrophic hormonal profile.

Subjects and Methods: Nineteen Egyptian girls aged (13.8- 21.6) years were recruited into the study.

Assessment of Pubertal development according to Marshall& Tanner (1969) was performed; and age at menarche was evaluated.

Auxological assessment (weight, height, and body mass index) were performed.

Laboratory investigations were done, including HbAlc levels and Hormone assays (basal and post stimulation levels): Scrum follicle- stimulating hormone (FSH), luteinizing hormone (LH), and LH/ FSH ratio was calculated.

Intervention: Girls underwent GnRH- analogue test with triptorelin (0.1 mg) administered subcutaneously.

Results: The mean age at menarche (13.24± 1.25) yrs, among the 17 (89.5%) postmenarchcal TIDM girls, showed no significant difference (P>0.05) from the normal population; but still 2 (10.5%) girls did not achieve menarche until after the study period was terminated.

Moreover, there was a highly significant delay (P< 0.01) in their attainment of adult sexual maturity Tanner stage V (B5, PH5).

Only 3 (15.8%) TIDM girls, had achieved optimal metabolic control, at (< 7.5%), while the remaining 16 (84.2%) had a statistically significant insufficient metabolic control (9.93+ 1.96) (P<0.00).

Also it was found that basal and stimulated LH& FSH levels were significantly decreased in TIDM girls (P<0.000).

Conclusion: Type 1 diabetes could affect pubertal development of girls, in the form of delay in their attainment of adult sexual maturity stages, Tanner Breast stage (B5) and Tanner Pubic Hair development (PH5); however, their age at menarche, is within the range of normal Egyptian girls.

The disease could alter their growth development, with a decrease in their height than the normal population.

LH and FSH were significantly decreased than normal reference ranges.