Розлади менструальної функції в дівчат: зв’язок із глікемічними порушеннями (гіперінсулінемією та дисглікемією) в умовах війни

Disorders of carbohydrate homeostasis are important contributors to the development of metabolic diseases, including diabetes mellitus, obesity, and cardiovascular pathology. The first manifestations of these conditions often emerge during childhood and adolescence. Objective — to determine the relationship between menstrual cycle disorders and carbohydrate metabolism parameters (dysglycemia and insulin resistance) in adolescent girls in the frontline Kharkiv. Materials and methods. A total of 286 adolescent girls with menstrual cycle disorders were examined. During 2018 — 2021, 133 patients were enrolled: 66 with abnormal uterine bleeding (AUB1) and 67 with oligomenorrhea (OM1). During 2022 — 2025, 153 adolescents were examined: 75 with abnormal uterine bleeding (AUB2) and 78 with oligomenorrhea (OM2). Anthropometric parameters, including height, body weight, and body mass index (BMI), were assessed. Serum glucose, triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and insulin levels were measured. The Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), Triglyceride-Glucose (TyG) index, and TG/HDL-C ratio were calculated. Results. Comparison of the parameters before and after the onset of the full-scale war demonstrated deterioration of carbohydrate metabolism parameters in girls exposed to chronic psychological stress. After 2022, mean glucose, insulin, and HOMA-IR values increased significantly. Carbohydrate metabolism disturbances were detected more frequently in patients with abnormal uterine bleeding than in those with oligomenorrhea. The most pronounced metabolic changes were observed in overweight and obese girls, whose insulin levels and HOMA-IR values substantially exceeded the reference ranges. Positive correlations were found between BMI and both hyperinsulinemia and insulin resistance: in patients with AUB, r=0.38 (p<0.001) and r=0.39 (p<0.0009), respectively; in those with OM, r=0.56 (p<0.0001) and r=0.57 (p<0.0001), respectively. Significant associations were also identified between triglyceride levels, insulin concentration, HOMA-IR, the TyG index, and the TG/HDL-C ratio. Conclusions. Residence in a frontline-affected region was associated with unfavorable changes in carbohydrate metabolism parameters, particularly among overweight and obese adolescent girls. The TyG index and TG/HDL-C ratio may serve as simple and cost-effective surrogate markers of insulin resistance and represent accessible alternatives to HOMA-IR for assessing insulin resistance in adolescents with menstrual cycle disorders.