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

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 and 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]: Serum 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%] postmenarcheal T1DM 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%] T1DM 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 and FSH levels were significantly decreased in T1DM 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

Adiponectin serum levels in adolescent boys with type 1 diabetes in relationships to pubertal grouth, development and glycemic control

Introduction: Adiponectin is a protein hormone secreted exclusive by adipocytes that regulate the metabolism of lipids and glucose. It has antidiabetic, antiatherogenic and anti-inflammatory properties

Objective: To asses adiponectin serum levels in adolescent boys with type development, body mass index [BMI], glycemic control and insulin dosage

Research design and methods: A case-control study was carried out on 45 adolescent boys with T1DM aged [12-18] years and 37 healthy control boys of similar age. Each of the cases and control groups were divided into four subgroups according to their Tanner stage .They were subjected to full history, reviewing medical records, auxology and pubertal stage assessment. Serum total adiponectin level was determined by ELISA technique in addition to giycatedhaemoglobin [HbAlc] and fasting blood glucose

Results: Mean adiponectin serum level [ +/- SD] was significantly higher in T1DM boys compared to healthy control group [12.93 +/- 5.24micro g/mlversus 8.91 +/- 3.21 micro g/ ml] [P<0.001] . Such higher serum levels of adiponectin were detected mainly at Tanner stage 2 [16.571 4.60 micro g/ mlvs 11.88 +/- 3.39 micro g/ ml] [P= 0.025] and Tanner stage 3 [12.77 +/- 3.71 micro g/ ml vs.6.59i 1.54 micro g ml] [P= 0.002]. Adiponectin level decreased significantly during pubertal development in control group and T1DM group. Adiponectin level was significantly higher in diabetic-poor controlled group than diabetic good-controlled group. Adiponectin was negatively correlated with pubertal stage, age, intermediate/ long acting insulin dose and positively correlated to HbAlc in diabetic group. In control group adiponectin levels were negatively correlated with pubertal stage and BMI

Conclusion: Adiponectin serum levels in adolescent boys with type 1 diabetes were significantly higher than control mainly at early puberty. It decreased significantly during pubertal development and was' strongly positively related to glycemic control