Diabetes Mellitus disrupts the sexual steroid milieu during pregnancy: effects of Type 2 (T2D) and gestational diabetes (GD) on Anti-Mullerian Hormone (AMH) levels of their offspring
Claudio Villarroel (CL), Patricia Lopez (CL), Abril Salinas (CL), Gustavo Rencoret (CL), Paulina Kohen (CL), Luigi Devoto (CL), Ethel Codner (CL)
[Villarroel] Institute for Mother and Child Research, University of Chile, [Lopez] Institute for Mother and Child Research, University of Chile, [Salinas] Institute for Mother and Child Research, University of Chile, [Rencoret] School of Medicine, University of Chile, [Kohen] Institute for Mother and Child Research, University of Chile, [Devoto] nstitute for Mother and Child Research, University of Chile, [Codner] nstitute for Mother and Child Research, University of Chile
Context: Higher androgen levels are observed in non-pregnant women with diabetes. Whether this hormonal profile is found during pregnancy and how this affect AMH levels of the female offsprings is unknown. Objective: The aim of this study was to determine the sexual steroids levels in pregnant women with pregestational Type 2 (T2D) and Gestational Diabetes (GD) compared to healthy control (C) pregnant women during the second half of pregnancy. To study the effect of maternal diabetes on ovarian function of female newborns (NB) and to assess the relationship of hormonal findings in the NB with her mother hormonal profile during pregnancy Methods: A prospective study of 69 pregnant women with T2D (N:21), GD (N:24) and C (N:24) was followed up during the second half of gestation. Assessment of the ovarian function of NB daughters of T2D (dT2D, n:20), GD (dGD, n:27), and Control (dC, N:22). Intervention: Clinical assessments and blood samples collected at 26.7 (25-27.8); 34 (32–34.9) and 37.5 (37–40) weeks of gestation. Clinical and blood cord sample were obtained at the moment of delivery. Main Outcome Measure: Androgens, SHBG, estradiol(E2), estradiol/testosterone ratio (E2/T), insulin, glucose, HOMA-IR, Results: Testosterone, insulin, and HOMA-IR levels were higher in T2D compared with C at each sampling point during pregnancy. E2 levels and E2/T were lower in T2D and GD compared with C. Higher AMH, HOMA-IR levels in dT2D than dGD and dC at delivery. Conclusions: Hyperandrogenemia is observed in T2D during pregnancy. Decreased E2/T found in T2D and GD suggests a diminished aromatase activity during gestation. T2D and GD are associated with specific changes in sexual steroids and insulin resistance levels during pregnancy. Daughters of women with T2D have higher AMH levels suggesting that DM during pregnancy affects ovarian function of the offspring