Diabetes-associated endometrial disruption in the Chinese hamster: structural changes in relation to progressive hyperglycemia.

Abstract

The relationship between progressive diabetes and endometrial structure was examined in genetically diabetic Chinese hamsters. Uterine samples were collected from animals exhibiting prediabetic to overt diabetic conditions and from matched control animals. In controls (with blood glucose levels less than or equal to 145 mg/dl) the endometrium was typified by an intact luminal epithelium, a thin underlying basement membrane and a well-organized stroma layer. In contrast, mildly diabetic (150-250 mg/dl) animals exhibited a compressed luminal epithelium which was embedded in a thickened basement membrane infiltrated with phagocytic blood elements. The stromal layer contained several irregular cells which were characterized by cytoplasmic vacuolization and collagen fiber separation by an amyloid-like, intercellular ground substance. In overt diabetic animals (greater than or equal to 300-500 mg/dl), the luminal epithelial cells were located over a greatly thickened basement membranes which was infiltrated by phagocytic blood elements and degenerating stromal cell membranes. The lumens of the glands were closed and the stromal cells were separated by an increased intercellular space occupied by an amyloid-like ground substance. Many stromal cells exhibited cytoplasmic vacuolization. These studies demonstrate that uterine involution associated with diabetes occurs in a sequential manner and is temporally related to progressive elevations in blood glucose levels.