Skip to main content
SpringerLink
Log in

Serum androgen levels in adolescents with type 1 diabetes: Relationship to pubertal stage and metabolic control

  • Original Article
  • Published:
Journal of Endocrinological Investigation Aims and scope Submit manuscript

Abstract

Delayed sexual maturation is still frequently seen in adolescents with type 1 diabetes. A close relationship between insulin and androgen metabolism has been found in a number of studies. Our study was designed to investigate whether or not abnormalities in androgen secretion could play a role in the onset of sexual maturation in adolescents with type 1 diabetes. We have asked whether or not there was a correlation between daily insulin dosage, duration of diabetes, metabolic control, age, pubertal stage, and body mass index (BMI) versus serum androgen concentrations. Basal total and free testosterone, dehydroepiandrosterone-sulfate (DHEA-S), dihydrotestosterone (DHT), sex hormone binding globulin (SHBG) and 3α-androstanediol glucuronide (3αdiol-G) plasma concentrations were measured in 36 pubertal boys and 31 pubertal girls with type 1 diabetes and in 59 sex- and pubertal stage-matched control subjects without diabetes. Significantly higher serum total testosterone (p<0.01) and free testosterone (p<0.05) levels were found in females and males with type 1 diabetes than in controls at pubertal stage 5. DHEA-S, SHBG, DHT and 3αdiol G concentrations in patients with diabetes were not significantly different from those in controls. There was no correlation between daily insulin requirements and serum androgen levels. These data suggest that adolescents with diabetes have similar serum levels of DHEA-S, SHBG, DHT and 3αdiol G as healthy subjects at all stages of puberty. However, there are significant differences in serum testosterone and free testosterone levels in adolescents with diabetes when compared to healthy, sex- and pubertal stage-matched controls in late puberty. We hypothesize that the increased testosterone levels in patients with diabetes could relate to reduced fertility in females, disorders of sexual maturation and an increased risk for cardiovascular complications later in life.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Dunger D.B. Diabetes in puberty. Arch. Dis. Child 1992, 67: 569–570.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  2. Amiel S.A., Sherwin R.S., Simonson D.C., Lauritano A.A., Tamborlane W.V. Impaired insulin action in puberty. A contributing factor to poor glycemic control in adolescents with diabetes. N. Engl. J. Med. 1986, 315: 215–219.

    Article  CAS  PubMed  Google Scholar 

  3. Holly J.M.P., Dunger D.B., Al-Othman S.A., Wass J.A.H. Sex hormone binding globulin levels in adolescent subjects with diabetes mellitus. Diabet. Med. 1992, 9: 371–374.

    Article  CAS  PubMed  Google Scholar 

  4. Rudberg S., Persson B. Indications of low sex hormone binding globulin (SHBG) in young females with type-1 diabetes, and an independent association to microalbuminuria. Diabet. Med. 1995, 12: 816–822.

    Article  CAS  PubMed  Google Scholar 

  5. Djursing H., Hagen C., Nyboe A.A., Svenstrup B., Bennet P., Molsted P.L. Serum sex hormone concentrations in insulin dependent diabetic women with and without amenorrhoea. Clin. Endocrinol. (Oxf.) 1985, 23: 147–154.

    Article  CAS  Google Scholar 

  6. Horton R., Lobo R. Peripheral androgens and the role of androstanediol glucuronide. J. Clin. Endocrinol. Metab. 1986, 15: 293–306.

    Article  CAS  Google Scholar 

  7. Rittner H.L., Lee P.D.K., Blum W.F., Doerr H., Steiss J., Kreuder J., Rascher W., Kiess W. 3-α Androstanediol glucuronide serum levels throughout childhood and adolescence in relation to sex, age, and pubertal stage: Implications for the long-term care of children with congenital adrenal hyperplasia. J. Endocrinol. Invest. 1997, 20: 245–250.

    CAS  PubMed  Google Scholar 

  8. Prader A., Largo A.H., Molinary L., Issler R.H. Physical growth in Swiss children from birth to 20 years of age. Helv. Paediatr. Acta 1989, 52: (Suppl.) 1.

    CAS  Google Scholar 

  9. Tanner J.M. Growth and adolescence, ed. 2. Oxford Blackwell Scientific, Oxford, 1962.

    Google Scholar 

  10. Kiess W., Past R., Meiler B., Kessler U., Strasser-Vogel B., Landgraf R. Immediate HbA1c measurements in the paediatric diabetes clinic: reliability, limitations and practical evaluation. Horm. Metab. Res. 1994, 26: 351–352.

    Article  CAS  PubMed  Google Scholar 

  11. Small M., Gray L.E., Beastall G.H. Adrenal androgens in IDDM. Diabetes Res. 1989, 11: 93–95.

    CAS  PubMed  Google Scholar 

  12. Rudberg S., Persson B. Indications of low sex hormone binding globulin (SHBG) in young females with type-1 diabetes, and an independent association to microalbuminuria. Diabetic Med. 1995, 12: 816–822.

    Article  CAS  PubMed  Google Scholar 

  13. Evans D.J., Hoffman R.G., Kalkhoff R.K., Kissebah A. Relationship of androgenic activity to body fat topography, fat cell morphology, and metabolic abnormalities in premenopausal women. J. Clin. Endocrinol. Metab. 1983, 57: 304–310.

    Article  CAS  PubMed  Google Scholar 

  14. Haffner S.M., Dunn J.F., Katz M.S. Relationship of sex hormone binding globulin to lipid, lipoprotein, glucose, and insulin concentrations in postmenopausal women. Metabolism 1992, 41: 278–284.

    Article  CAS  PubMed  Google Scholar 

  15. Haffner S.M., Katz M.S., Stern M.P., Dunn J.F. The relationship of sex hormones to hyperinsulinemia and hyperglycemia. Metabolism 1988, 37: 683–688.

    Article  CAS  PubMed  Google Scholar 

  16. Haffner S.M., Valdez R.A., Mykkänen L., Stern M.P., Katz M.S. Decreased testosterone and dehydroepiandrosterone sulfate concentrations are associated with increased insulin and glucose concentrations in nondiabetic men. Metabolism 1994, 43: 599–603.

    Article  CAS  PubMed  Google Scholar 

  17. Beck-Nielsen H., Richelsen B., Hasling C., Nielsen O.H., Heding L., Sorensen N.S. Improved in vivo insulin effect during continuous subcutaneous insulin infusion in patients with IDDM. J. Clin. Endocrinol. Metab. 1984, 33: 721–732.

    Google Scholar 

  18. Plymate S.R., Jones R.E., Matej L.A., Friedl K.E. Regulation of sex hormone binding globulin (SHBG) production in Hep G2 cells by insulin. Steroids 1988, 52: 339–422.

    Article  CAS  PubMed  Google Scholar 

  19. Vague V.L., Raccah D., Pugeat M., Bautrant D., Belicar P., Vague P. SHBG (Sex hormone binding globulin) levels in insulin dependent diabetic patients according to the route of insulin administration. Horm. Metab. Res. 1994, 26: 436–437.

    Article  PubMed  Google Scholar 

  20. Poretsky L. On the paradox of insulin-induced hyperandrogenism in insulin-resistant states. Endocr. Rev. 1991, 12: 3–13.

    Article  CAS  PubMed  Google Scholar 

  21. Barbieri R.L., Makris A., Randall R.V., Daniels G., Kistner R.V., Ryan K.J. Insulin stimulated androgen accumulation in incubations of ovarian stroma obtained from women with hyperandrogenism. J. Clin. Endocrinol. Metab. 1986, 62: 904–926.

    Article  CAS  PubMed  Google Scholar 

  22. Velhius K.D., Toaff M.E., Strauss J.F., Demers L.N. Mechanisms subserving the tropic action of insulin on ovarian cells: in vitro studies using swine granulosa cells. J. Clin. Invest. 1988, 72: 1046–1057.

    Google Scholar 

  23. Diamond M.P., Grainger D.A., Laudano A.J., Starick-Zych K., DeFronzo R.A. Effect of acute physiological elevations of insulin on circulating androgen levels in nonobese women. J. Clin. Endocrinol. Metab. 1991, 72: 883–887.

    Article  CAS  PubMed  Google Scholar 

  24. Dunaif A., Graf M. Insulin administration alters gonadal steroid metabolism independent of changes in gonadotropin secretion in insulin-resistant women with polycystic ovary syndrome. J. Clin. Invest. 1989, 83: 23–29.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  25. Stuart C.A., Prince M.J., Peters E.J., Mejer M.J. Hyperinsulinemia and hyperandrogenemia: in vivo androgen response to insulin infusion. Obstet. Gynecol. 1987, 69: 921–925.

    CAS  PubMed  Google Scholar 

  26. Carlson M.G., Campbell P.J. Intensive insulin therapy and weight gain in IDDM. Diabetes 1993, 42: 1700–1707.

    Article  CAS  PubMed  Google Scholar 

  27. Abusrewil S.S., Savage D.C.L. Obesity and diabetic control. Arch. Dis. Child 1989, 64: 1313–1315.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  28. Zumoff B. Hormonal abnormalities in obesity. Acta Med. Scand. 1988, (Suppl.) 723: 153–156.

    Google Scholar 

  29. Virtanen S.M. Metabolic control and diet in Finnish diabetic adolescents. Acta Paediatr. 1992, 81: 239–243.

    Article  CAS  PubMed  Google Scholar 

  30. Zachrisson I., Wallensteen M., Dahlquist G. Determinants of blood glucose variability in adolescents with insulin-dependent diabetes mellitus. Acta Paediatr. 1995, 84: 70–74.

    Article  CAS  PubMed  Google Scholar 

  31. Deslypere J.P., Sayed A., Punjabi U., Verdonck L., Vermeulen A. Plasma 5 α-androstane-3α, 17β-diol and urinary 5α androstane-3α, 17β glucuronide, parameters of peripheral androgen action: a comparative study. J. Clin. Endocrinol. Metab. 1982, 54: 386–391.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Children’s Hospital, University of Leipzig, Leipzig, Germany

    K. Meyer, J. Deutscher, A. Berthold, M. Bartsch & Wieland Kiess M.D.

  2. Children’s Hospital, University of Giessen, Oststr. 21-25, 04317, Leipzig, Germany

    M. Anil

Authors
  1. K. Meyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. Deutscher
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Anil
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Berthold
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. Bartsch
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Wieland Kiess M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Wieland Kiess M.D..

Rights and permissions

Reprints and permissions

About this article

Cite this article

Meyer, K., Deutscher, J., Anil, M. et al. Serum androgen levels in adolescents with type 1 diabetes: Relationship to pubertal stage and metabolic control. J Endocrinol Invest 23, 362–368 (2000). https://doi.org/10.1007/BF03343739

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03343739

Key words

Search

Navigation