Endocrine Abstracts

Introduction: The aim of this study was to investigate the degree of atherosclerosis in women of reproductive age with type 2 diabetes mellitus (T2DM), with and without polycystic ovary syndrome (PCOS).

Patients and Methods: 71 women (mean age 43.2 y) with T2DM treated with diet or oral anti-diabetic medications and 36 controls were studied. According to menstrual cycle and clinical hyperandrogenism, patients with T2DM were classified into two subgroups, 53 without PCOS (T2DM+PCOS-) and 18 with PCOS (T2DM+PCOS+). After overnight fast in the first phase of menstrual cycle, hormonal and biochemical measurements were recorded, while the carotid intima-media thickness (IMT) was measured.

Results: Women with T2DM presented significantly higher BMI (34.5±6.39 vs 27.9±6.1, P<0.001), waist circumference (105.3±14 vs 86.9±11.2, P<0.001), hirsutism (1.78±0.9 vs 1.15±0.3, P<0.01) and family history of T2DM (82.5% vs. 34.6%, P<0.002). They also had significantly higher total testosterone (0.62±0.21 vs 0.45±0.11, P<0.001), insulin (17.8±11.9 vs 9.8±3.6, P<0.002), triglycerides (131±23 vs 95±67, P=0.02) and LDL cholesterol levels (132±31 vs 114±23, P=0.025), while lower SHBG (34.3±16.2 vs 53.9±18.7, P<0.001) and HDL cholesterol levels (47.1±12.8 vs. 57±10.9, P<0.001) compared to controls. T2DM+PCOS+ patients reported a significantly higher rate of gestational diabetes (37.5% vs. 8.3%, P<0.05), younger age of diagnosis of T2DM (32.8±5.7 vs. 39.7±6.1, P<0.001) and presented significantly higher waist circumference (115±12.8 vs. 99±11.1, P<0.01) compared to T2DM+PCOS- patients. They also had higher levels of total testosterone (0.75 0.22 vs 0.54±0.16, P=0.01) and insulin levels (24±15.8 vs 14.4±7.5, P<0.05), lower SHBG (26.1±9.5 vs 39.8±17.6, P<0.001) and HDL-cholesterol levels (41.4±11.2 vs 50.8±12.6, P<0.001). The degree of atherosclerosis as assessed by IMT was significantly higher in patients with T2DM compared to controls (0.065±0.007 vs 0.056±0.008, P<0.001), but did not differ significantly between the two subgroups of patients with T2DM.

Conclusion: The results of this study provided evidence that women of reproductive age with T2DM present early atherosclerosis compared to healthy controls, but the coexistence of PCOS does not seem to additionally deteriorate the degree of clinical atherosclerosis.