Insulin resistance and potential modulators of ovarian reserve in young reproductive-aged women with obesity and type 1 diabetes

Abstract

Introduction

Both obesity and diabetes play a significant role in reproductive disorders in women and insulin resistance (IR) is a confirmed trait d’union. We evaluated the relationship between IR and an established ovarian reserve biomarker such as anti-mullerian hormone (AMH) together with other potential modulators of ovarian physiology (adiponectin and kisspeptin) in young reproductive-aged group women with obesity and type 1 diabetes (T1D).

Patients and methods

We recruited 32 female youths: 14 of them presented with T1D (14.6 ± 2.6 years) and 18 with obesity (15.1 ± 2.6 years). The control group included 20 age-matched normal weight females. Each patient underwent physical examination and hormonal assessment. AMH, kisspeptin and adiponectin levels were also measured. IR was calculated as the homeostasis model assessment for insulin resistance (HOMA-IR) and the glucose disposal rate (eGDR) in patients with obesity and with T1D, respectively.

Results

adiponectin and kisspeptin levels were significantly different into groups (p ≤ .001), whereas AMH levels were not. Adiponectin values were higher in controls compared to patients with obesity (p < .001) and T1D (p = .02). Kisspeptin levels were lower in controls compared to patients with obesity (p = .001), without reaching statistical significance when compared to T1D (p = .06). IR was associated with lower adiponectin and higher kisspeptin levels (p < .001 and p = .02, respectively), but not with AMH.

Conclusions

IR displays a relationship with adiponectin and kisspeptin in young reproductive-aged women with obesity and T1D. Interventions to correct IR in adolescents could be part of an early approach to prevent reproductive disorders and to promote factors associated with longevity in adult women.

伴有肥胖症和1型糖尿病年轻育龄女性的胰岛素抵抗和卵巢储备的潜在调节剂 摘要

介绍：肥胖症和糖尿病都在女性生殖障碍中起着重要作用, 胰岛素抵抗是一个确定的特征。我们评估了肥胖症和1型糖尿病(T1D)年轻育龄女性中胰岛素抵抗与已建立的卵巢储备生物标志物(如抗苗勒管激素(AMH)以及其他潜在的卵巢生理调节剂(脂联素和黑色素转移抑制基因))之间的关系。

患者和方法:我们招募了32名女性青年:其中14人患有T1D(14.6±2.6岁), 18人患有肥胖症(15.1±2.6岁)。对照组为20名年龄相仿、体重正常的女性。每位患者都接受了体格检查和激素评估, 还测定了AMH、黑色素转移抑制基因和脂联素水平。分别计算肥胖患者和T1D患者的胰岛素抵抗(HOMA-胰岛素抵抗)和葡萄糖处理率(eGDR)的稳态模型评估。

结果:脂联素和黑色素转移抑制基因水平在组间有显著性差异(p≤. 001), 而AMH水平无显著差异。与肥胖患者(p < .001)和T1D患者(p < 0.02)相比, 对照组的脂联素值更高。与肥胖患者相比, 对照组的黑色素转移抑制基因水平较低(p .001)；与T1D相比, 对照组的黑色素转移抑制基因水平则无统计学意义(p .06)。胰岛素抵抗与较低的脂联素和较高的黑色素转移抑制基因水平有关(分别p < .001和p .02), 但与AMH无关。

结论:在肥胖和T1D的年轻育龄女性中, 胰岛素抵抗与脂联素和黑色素转移抑制基因有关。纠正青少年胰岛素抵抗的干预措施可能成为预防生殖障碍和促进成年女性长寿相关因素的早期方法的一部分。

Keywords:

• Young reproductive-aged women
• obesity
• type 1 diabetes
• ovarian reserve
• adiponectin
• kisspeptin
• AMH

Acknowledgements

We are very grateful to Giorgia Testa, Cristina Torre for their technical assistance.

Disclosure statement

The authors have no competing interests to declare.

Additional information

Funding

The authors did not receive any funding from public, commercial or not-for-profit agencies to conduct this research.