Reproductive history and hormonal birth control use are associated with coronary calcium progression in women with type 1 diabetes mellitus

J Clin Endocrinol Metab. 2008 Jun;93(6):2142-8. doi: 10.1210/jc.2007-2025. Epub 2008 Mar 18.

Abstract

Context: Coronary artery disease is increased in women with type 1 diabetes (T1D), compared with nondiabetic (Non-DM) women. Women with T1D have more menstrual dysfunction and are less likely to use hormonal birth control (BC) than Non-DM women.

Objective: The purpose of this study was to determine whether coronary artery calcium (CAC) is associated with menstrual dysfunction and BC use in women with T1D.

Materials and methods: This was a prospective cohort study, and participants were followed up for an average of 2.4 yr.

Patients: Patients included 612 women (293 T1D, 319 Non-DM) between the ages of 19 and 55 yr who had CAC measured twice by electron beam tomography.

Results: Irregular menses and amenorrhea were more common in T1D than Non-DM women (22.1 vs. 14.9%, P < 0.05 and 16.6 vs. 7.0%, P < 0.001). T1D women reported less BC use than Non-DM women (79.8 vs. 89.9%, P < 0.001) and reached menarche at an older age (13.1 +/- 1.8 vs. 12.8 +/- 1.5 yr, P < 0.05). Use of BC was associated with less CAC progression in all women, but this association was stronger in T1D women (P value for interaction = 0.02). Irregular menses were associated with greater CAC progression only among T1D women.

Conclusions: A prior history of BC use is associated with reduced CAC progression among all women, with a stronger association in T1D than in Non-DM women. Women with T1D who report irregular menses have increased CAC progression, compared with those with regular menses.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Calcinosis / etiology*
  • Calcium / metabolism
  • Cohort Studies
  • Contraception / adverse effects*
  • Contraceptive Agents, Female / adverse effects
  • Contraceptive Agents, Female / therapeutic use
  • Coronary Artery Disease / etiology*
  • Diabetes Mellitus, Type 1 / complications*
  • Disease Progression
  • Female
  • Humans
  • Middle Aged
  • Reproductive History*
  • Risk Factors
  • Time Factors

Substances

  • Contraceptive Agents, Female
  • Calcium