Differential effect of two hormonal contraceptives on the relative telomere length of youth with type 1 diabetes

Abstract Context Adolescents and young women (AYA) with type 1 diabetes (T1D) may require hormonal contraception for an extended period. However, it is unclear what effect hormonal contraception has on telomere length, a marker of the risk for complications. Objectives To investigate the relative telomere length (RTL) in AYA with T1D (AYA-T1D) and healthy young women (AYA-C) after 18 months of combined oral contraception use (COC) with ethinyl estradiol/desogestrel, or a subdermal etonogestrel implant (IM). Methods A non-randomized prospective study was performed. Thirty-nine AYA-T1D and forty AYA-C chose the COC or the IM. RTL was measured by monochrome multiplex quantitative PCR in DNA from peripheral blood mononuclear cells (PBMC). The impact of contraceptives and clinical variables on RTL was assessed using lineal regression analysis. Results Longer RTL compared to baseline was observed in AYA-T1D (P< 0.05) and AYA-C (P<0 .01) after using the IM. However, the total of AYA and the AYA-C group treated with COC decreased RTL after 18 months of treatment compared to baseline (P< 0.05). The type of contraceptive used was determinant for the changes in RTL compared to baseline in all subjects and controls (P≤ .006). For AYA-T1D, HbA1c levels were not associated with RTL, but the high-sensitivity C-reactive protein was negatively related with the changes in RTL at eighteen months compared to baseline (standardized R2: .230, P=.003). Conclusion IM was associated with longer RTL in AYA-T1D and AYA-C. In contrast, a shortening of telomere length in PMNC was observed after using COC.