This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Snell-Bergeon, J. K. Articles by Rewers, M. Search for Related Content PubMed PubMed Citation Articles by Snell-Bergeon, J. K. Articles by Rewers, M. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Medline Plus Health Information Birth Control Coronary Artery Disease Diabetes Type 1 Hazardous Substances DB CALCIUM COMPOUNDS CALCIUM, ELEMENTAL Related Collections Cardiovascular Endocrinology Diabetes and Insulin Female Endocrinology

Reproductive History and Hormonal Birth Control Use Are Associated with Coronary Calcium Progression in Women with Type 1 Diabetes Mellitus

Barbara Davis Center for Childhood Diabetes (J.K.S.-B., G.L.K., M.R.) and Departments of Preventive Medicine and Biometrics (D.D., L.G.O., J.E.H.) and Medicine (J.E.), University of Colorado at Denver and Health Sciences Center, Denver, Colorado 80045; and George Washington University Medical Center (J.E.), Washington, D.C. 20037

Address all correspondence and requests for reprints to: Janet K. Snell-Bergeon, Barbara Davis Center for Childhood Diabetes, University of Colorado at Denver and Health Sciences Center, P.O. Box 6511, Mail Stop A-140, Aurora, Colorado 80045. E-mail: janet.snell-bergeon{at}uchsc.edu.

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.

This article has been cited by other articles:

				C. L. Shufelt and C. N. Bairey Merz Contraceptive hormone use and cardiovascular disease. J. Am. Coll. Cardiol., January 20, 2009; 53(3): 221 - 231. [Abstract] [Full Text] [PDF]