Evaluation of relationship between HbA1c levels and ovarian reserve in patients with type 1 diabetes mellitus

Abstract

In organ or non-organ-specific autoimmune disorders, human ovary is usually the target of the autoimmune attack. We aimed to demonstrate the correlation between ovarian reserve and DM1, based on the view that women with type-1 diabetes mellitus (DM1) will have lower AMH levels secondary to poor glycemic control and autoimmune attacks. Ovarian functions of 42 patients diagnosed with DM1 who use insulin and 65 healthy volunteers were analyzed. Basal hormone and AMH levels were measured during the follicular phase. Fasting and postprandial blood glucose concentrations, HbA1c and C-peptide levels were evaluated. The mean antral follicle count (AFC) was significantly lower in DM1 patients than in healthy controls (p = .001). The AMH levels were lower in women with DM1 than in the controls (p = .001). The HbA1c values of DM1 patients, who formed the study group, was significantly higher than the control group. Ovarian reserve that is evaluated with serum AMH level is affected by poor glycemic control in type 1 diabetes. Due to the time of the autoimmune damage in the ovaries and the observable effects of this damage, more comprehensive and longer-term studies are needed to be conducted for the follow-up of reproductive abnormalities.

摘要

在器官或非器官特异性自身免疫病中, 人卵巢常常是自身免疫攻击的目标。基于1型糖尿病（DM1）的女性患者, 由于继发性血糖控制不良和自身免疫性攻击导致AMH水平较低的观点, 我们的研究目的是证明卵巢储备与DM1之间的相关性。研究分析了42名应用胰岛素的DM1患者和65名健康人的卵巢功能。在卵泡期测量基础激素和AMH水平。测定空腹和餐后血糖浓度、糖化血红蛋白和C肽水平。DM1组平均窦卵泡计数（AFC）明显低于健康对照组（p=.001)。研究组DM1患者的糖化血红蛋白值明显高于对照组（p=.001)。用血清AMH水平评估1型糖尿病血糖控制不良的患者的卵巢储备功能。由于卵巢自身免疫损害发生的时间较长, 且影响明显, 因此需要对生殖系统进行更全面和长期的随访。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Antral follicle count
• anti-müllerian hormone
• ovarian reserve
• type 1 diabetes mellitus
• HbA1c

Disclosure statement

No potential conflict of interest was reported by the authors.