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|Title||Polycystic Ovary Syndrome in Women with Type1 Diabetes in Gaza Governorate|
|Title in Arabic||متلازمة تكيس المبايض لدى النساء المصابات بالسكري من النوع الاول في محافظة غزة|
Background: Women with type 1 diabetes depend on insulin injections throughout their life. However, recommendation for strict metabolic control of diabetes requires the administration of supra-physiological doses of insulin, which might result in insulin-mediated stimulation of androgen synthesis. Hyperandrogensim in women with type 1 diabetes may be associated with polycystic ovary syndrome (PCOS). Objective: To determine PCOS and associated clinical symptoms and biochemical alterations in women with type1 diabetes in Gaza Governorate. Materials and Methods: This case-control study comprised 50 type 1 diabetic women selected from Medical Relief Center in Gaza Governorate and 50 apparently healthy non diabetic controls. Questionnaire interviews were applied. Anthropometric measurements were preformed. Serum total testosterone, follicle stimulating hormone (FSH), luteinizing hormone (LH), and insulin were measured by ELSA. Data were analyzed using SPSS version 18.0. Results: The mean ages of controls and cases were 23.8±5.2 and 23.3±5.7 years. The mean period of first delivery after marriage was significantly longer in cases compared to controls. Type 1 diabetes was more prevalent among less educated and unemployed women as well as among women with family history of diabetes. The mean of waist to hip ratio was higher in diabetic women compared to controls. The mean age of menarche was significantly higher in diabetic women compared to controls (13.9±1.6 vs 13.2±1.2 years, P=0.020). The presenting symptoms including acanthosis nigricanse, seborrhea and hirsutism were more prevalent in cases compared to controls. The levels of total testosterone and insulin were significantly higher in cases compared to controls (0.58±0.11 and 15.8±12.4 vs 0.44±0.11 and 10.8±4.5, % difference=26.3 and 37.6%, P=0.000 and 0.010, respectively). Polycystic ovary syndrome was present in 11 (22.0%) out of 50 cases compared with 3 (6.0%) in controls (c2(corrected) =4.070, P= 0.044). There was significant increase in PCOS frequency in cases with intensive insulin treatment 9 out of 22 (40.9%) compared to 2 out of 28 (7.1%) with non intensive insulin treatment. The Mean of waist to hip ratio was higher in PCOS than non PCOS cases. The mean insulin dose received by PCOS was significantly higher than non PCOS cases (72.7± 23.9 vs 55±19.8 U.I cc/ml, P=0.023). Oligomenenorrhoa was reported in 11 cases with PCOS compare to 6 cases without PCOS (c2(corrected)=23.735, P=0.000). In addition, the mean age of menarche was higher in PCOS than non PCOS cases. The mean levels of testosterone and insulin were significantly higher in cases with PCOS compared to cases without PCOS (0.64±0.09 and 23.1±13.0 vs 0.53±o.11 and 14.1±11.8, P=0.023 and 0.041, respectively). Conclusion: Intensive insulin treatment was more frequently received by PCOS cases. Oligomenenorrhoa and increased levels of testosterone and insulin were the main features of PCOS.
|Publisher||الجامعة الإسلامية - غزة|
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