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Shi D, Du J, Kang H, Feng L, Liu F. The effect of subclinical hypothyroidism on hormonal and metabolic profiles and ovarian morphology in patients with polycystic ovary syndrome: a cross-sectional study. Gynecol Endocrinol 2024; 40:2358219. [PMID: 38835150 DOI: 10.1080/09513590.2024.2358219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 05/14/2024] [Indexed: 06/06/2024] Open
Abstract
OBJECTIVES Polycystic ovary syndrome (PCOS) and subclinical hypothyroidism (SCH) are prevalent gynecological conditions. However, the interrelationship between the two remains elusive. This study aims to elucidate the association between these conditions and determine the potential impact of SCH on the physiological and metabolic characteristics of patients with PCOS. METHODS This cross-sectional study enrolled 133 patients with PCOS from our Hospital. Participants were categorized into two groups: those with PCOS + SCH (n = 58) and those with PCOS (n = 75). Serum hormonal levels, metabolic markers, ovarian volume, and follicle count were compared between the groups. RESULTS There was a significant difference in BMI between the two groups, with a higher prevalence of obesity in the PCOS + SCH group (p = .014). Compared to the PCOS group, patients with PCOS + SCH had significantly higher levels of TSH (p < .001), triglycerides (p = .025), and HOMA-IR (p < .001), while LH levels were significantly lower (p = .048). However, multivariate linear regression analysis revealed that TSH, triglycerides, LH, and HOMA-IR were not determinants for the occurrence of SCH in patients with PCOS. Additionally, there was a notable reduction in follicle count in the left ovary for the PCOS + SCH group compared to the PCOS group (p = .003), and the overall follicle diameter of the PCOS + SCH group was also smaller (p = .010). CONCLUSION SCH may exert effects on the physiological and metabolic profiles of patients with PCOS. Further investigation into the relationship between these disorders is warranted to delineate their clinical implications.
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Affiliation(s)
- Dongmei Shi
- Reproductive Medicine Centre, Yinchuan Women and Children Health Care Hospital, Yinchuan, PR China
| | - Juan Du
- Reproductive Medicine Centre, Yinchuan Women and Children Health Care Hospital, Yinchuan, PR China
| | - Huixian Kang
- Reproductive Medicine Centre, Yinchuan Women and Children Health Care Hospital, Yinchuan, PR China
| | - Liping Feng
- Reproductive Medicine Centre, Yinchuan Women and Children Health Care Hospital, Yinchuan, PR China
| | - Fang Liu
- Reproductive Medicine Centre, Yinchuan Women and Children Health Care Hospital, Yinchuan, PR China
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Benelli E, Marradi M, Sciarroni E, Di Cosmo C, Bagattini B, Del Ghianda S, Simoncini T, Fruzzetti F, Tonacchera M, Fiore E. Thyroid autoimmunity in different phenotypes of polycystic ovary syndrome: a single-center experience. J Endocrinol Invest 2024:10.1007/s40618-024-02404-4. [PMID: 38850509 DOI: 10.1007/s40618-024-02404-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 05/29/2024] [Indexed: 06/10/2024]
Abstract
PURPOSE Polycystic ovary syndrome (PCOS) has been associated with Hashimoto's thyroiditis (HT) and 4 phenotypes have been described in this syndrome. The aim of this work was to investigate the frequency of anti-thyroid antibodies (TAb) and thyroid function in the 4 phenotypes of PCOS. PATIENTS This study included 448 patients with PCOS: 260 (58.0%) with phenotype A, 119 (26.6%) with phenotype B, 38 (8.5%) with phenotype C and 31 (6.9%) with phenotype D. RESULTS TAb positivity was detected in 90/448 patients (20.1%) and was statistically significant higher (p = 0.03) in the grouped phenotypes A-B (83/379, 21.9%) than in phenotypes C-D (7/69, 10.1%). Positive anti-thyroglobulin antibodies (TgAb) were detected in 74/448 (16.5%) patients and positive anti-thyroperoxidase antibodies (TPOAb) in 66/448 (14.7%) patients. Both TgAb and TPOAb positivity was higher but not statistically significant in phenotype A-B than phenotype C-D. High titer TgAb (> 100 UI/ml) frequency was significantly higher (p = 0.005) in grouped phenotypes A-B (39/379, 10.3%) than in phenotypes C-D (0/69, 0.0%), while no significant difference was observed for low titer TgAb (≤ 100 UI/ml). According to a binary logistic regression analysis hypothyroidism was significantly associated with TAb positivity (OR 4.19; CI 2.25-7.79; p < 0.01) but not with PCOS phenotype. Androgen profile was not associated with TAb positivity. CONCLUSION A higher frequency of positive TAb and of high titer TgAb and TPOAb have been detected in PCOS women with phenotypes A and B, probably in relation to the greater imbalances between estrogen and progesterone levels present in these phenotypes.
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Affiliation(s)
- E Benelli
- Department of Clinical and Experimental Medicine, Section of Endocrinology, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Pisa, Italy
| | - M Marradi
- Department of Clinical and Experimental Medicine, Section of Endocrinology, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Pisa, Italy
| | - E Sciarroni
- Department of Clinical and Experimental Medicine, Section of Endocrinology, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Pisa, Italy
| | - C Di Cosmo
- Department of Clinical and Experimental Medicine, Section of Endocrinology, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Pisa, Italy
| | - B Bagattini
- Department of Clinical and Experimental Medicine, Section of Endocrinology, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Pisa, Italy
| | - S Del Ghianda
- Department of Clinical and Experimental Medicine, Section of Endocrinology, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Pisa, Italy
| | - T Simoncini
- Department of Obstetrics and Gynecology, University Hospital of Pisa, Pisa, Italy
| | - F Fruzzetti
- Department of Obstetrics and Gynecology, University Hospital of Pisa, Pisa, Italy
| | - M Tonacchera
- Department of Clinical and Experimental Medicine, Section of Endocrinology, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Pisa, Italy
| | - E Fiore
- Department of Clinical and Experimental Medicine, Section of Endocrinology, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Pisa, Italy.
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Palomba S, Colombo C, Busnelli A, Caserta D, Vitale G. Polycystic ovary syndrome and thyroid disorder: a comprehensive narrative review of the literature. Front Endocrinol (Lausanne) 2023; 14:1251866. [PMID: 37635968 PMCID: PMC10453810 DOI: 10.3389/fendo.2023.1251866] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 07/28/2023] [Indexed: 08/29/2023] Open
Abstract
Background Published data on the relationship between polycystic ovary syndrome (PCOS) and thyroid dysfunction are sparse and confusing. Objective To comprehensively review data available in the literature regarding the relationship between PCOS and the thyroid function, and its abnormalities. Methods Nine main areas of interest were identified and analyzed according to the available evidence: 1) Evaluation of thyroid function for PCOS diagnosis; 2) Epidemiology data on thyroid function/disorders in patients with PCOS, and vice versa; 3) Experimental data supporting the relationship between thyroid function/disorders and PCOS; 4) Effects of thyroid function/disorders on PCOS features, and vice versa; 5) Effect of thyroid alterations on the cardiometabolic risk in women with PCOS; 6) Effect of thyroid abnormalities on reproductive outcomes in women with PCOS; 7) Relationship between thyroid function/abnormalities in patients with PCOS who are undergoing fertility treatment; 8) Effect of treatments for thyroid diseases on PCOS; and 9) Effect of treatments for PCOS on thyroid function. An extensive literature search for specific keywords was performed for articles published from 1970 to March 2023 using PubMed and Web of Science. Data were reported in a narrative fashion. Results PCOS is a diagnosis of exclusion for which diagnosis is possible only after excluding disorders that mimic the PCOS phenotype, including thyroid dysfunctions. However, the tests and the cutoff values used for this are not specified. Many experimental and clinical data suggest a relationship between perturbations of the thyroid function and PCOS. Direct and unequivocal evidence on the effects of thyroid function/disorders on PCOS features are lacking. High thyroid-stimulating hormone levels and subclinical hypothyroidism may be associated with significant worsening of several intermediate endpoints of cardiometabolic risk in women with PCOS. Thyroid abnormalities may worsen reproductive outcomes, especially in patients undergoing fertility treatment. To date, there are no data demonstrating the efficacy of thyroid medications on fertility and cardiometabolic risk in women with PCOS. Lifestyle modification changes, metformin, and vitamin D seem to improve thyroid function in the general population. Conclusion PCOS and thyroid disorders are closely related, and their coexistence may identify patients with a higher reproductive and metabolic risk. Regular screening for thyroid function and thyroid-specific autoantibodies in women with PCOS, particularly before and during pregnancy, is highly recommended.
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Affiliation(s)
- Stefano Palomba
- Division of Gynecology, Sant’Andrea Hospital, University “Sapienza” of Rome, Rome, Italy
| | - Carla Colombo
- Division of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Andrea Busnelli
- Department of Gynecology, Division of Gynecology and Reproductive Medicine, Fertility Center, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Donatella Caserta
- Division of Gynecology, Sant’Andrea Hospital, University “Sapienza” of Rome, Rome, Italy
| | - Giovanni Vitale
- Department of Medical Biotechnology and Translational Medicine (BIOMETRA), University of Milan, Milan, Italy
- Laboratory of Geriatric and Oncologic Neuroendocrinology Research, Istituto Auxologico Italiano, IRCCS, Milan, Italy
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Hochberg A, Badeghiesh A, Baghlaf H, Dahan MH. The association between hypothyroidism and perinatal outcomes in patients with polycystic ovary syndrome. Arch Gynecol Obstet 2023; 308:291-299. [PMID: 37149829 DOI: 10.1007/s00404-023-07063-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/25/2023] [Indexed: 05/08/2023]
Abstract
PURPOSE To compare pregnancy, delivery, and neonatal outcomes in patients with polycystic ovary syndrome (PCOS) with and without concomitant hypothyroidism. METHODS A retrospective population-based cohort study including all women with an ICD-9 diagnosis of PCOS in the US between 2004 and 2014, who delivered in the third trimester or had a maternal death. We compared women with a concomitant diagnosis of hypothyroidism to those without. Women with hyperthyroidism were excluded. Pregnancy, delivery, and neonatal outcomes were compared between the two groups. RESULTS Overall, 14,882 women met inclusion criteria. Among them, 1882 (12.65%) had a concomitant diagnosis of hypothyroidism, and 13,000 (87.35%) did not. Women with concomitant hypothyroidism, compared to those without, were characterized by increased maternal age (25.5% ≥ 35 years vs. 18%, p < 0.001, respectively), and had a higher rate of multiple gestations (7.1% vs. 5.7%, p = 0.023). Interestingly, pregnancy, delivery and neonatal outcomes were comparable between the groups, except for a higher rate of small-for-gestational-age (SGA) neonates in the group with hypothyroidism (4.1% vs. 3.2%, p = 0.033) (Tables 2 and 3). In a multivariate logistic regression adjusting for potential confounders, hypothyroidism was no longer found to be associated with SGA (adjusted odds ratio [aOR] 1.32, 95% confidence interval [CI] 0.99-1.75, p = 0.057), but was found to increase the odds for preeclampsia (aOR 1.30, 95% CI 1.06-1.59, p = 0.012). CONCLUSIONS In patients with PCOS, concomitant hypothyroidism significantly increases the risk for preeclampsia. Unexpectedly, other pregnancy complications commonly increased by hypothyroidism were not increased in women with PCOS, likely due to the inherent elevated baseline pregnancy risks of PCOS.
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Affiliation(s)
- Alyssa Hochberg
- Department of Obstetrics and Gynecology, McGill University, 845 Rue Sherbrooke, O, Montreal, QC, 3HA 0G4, Canada.
- The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Ahmad Badeghiesh
- Department of Obstetrics and Gynecology, Western University, London, ON, Canada
| | - Haitham Baghlaf
- Department of Obstetrics and Gynecology, McGill University, 845 Rue Sherbrooke, O, Montreal, QC, 3HA 0G4, Canada
| | - Michael H Dahan
- Department of Obstetrics and Gynecology, McGill University, 845 Rue Sherbrooke, O, Montreal, QC, 3HA 0G4, Canada
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Rajbanshi I, Sharma VK, Tuladhar ET, Bhattarai A, Raut M, Dubey RK, Koirala P, Niraula A. Metabolic and biochemical profile in women with polycystic ovarian syndrome attending tertiary care centre of central NEPAL. BMC Womens Health 2023; 23:208. [PMID: 37118753 PMCID: PMC10148396 DOI: 10.1186/s12905-023-02379-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 04/20/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND Polycystic Ovarian Syndrome (PCOS) is a common endocrinopathy in women of reproductive age group and is highly associated with an increased risk of diabetes, hypertension, cardiovascular disease, and hyper estrogen-related malignancies in women with PCOS. This study was intended to assess the metabolic and hormonal profile of the patients with polycystic ovarian syndrome attending a tertiary care hospital. METHODOLOGY A descriptive cross-sectional study was conducted among 107 women diagnosed with polycystic ovarian syndrome from the Department of Clinical Biochemistry of Tribhuvan University and Teaching Hospital. Descriptive analysis was performed to determine the socio-demographic characteristics of the participants. Bivariate analysis was conducted to determine using a t-test for comparing means between two groups and ANOVA for comparing the hormonal and metabolic parameters. RESULTS The mean age of the participants was 27 ± 4 years. This study showed that blood pressure was significantly higher in overweight and obese women (p = 0.001). The obese group had significantly higher serum TSH than the normal group (10.04 vs. 2.73, p = 0.001). Abnormal glucose and hyperinsulinemia were present in 4% of the patients, while 40% had Vitamin D deficiency. Hypothyroidism (TSH ≥ 4.5 mIU/ml) was found in 11% of the PCOS participants with a mean value of 6.65 ± 21.17 mIU/ml. Hyperprolactinemia ≥ 26.8 ng/ml was depicted in 21% of the study population with a mean value of 37.25 ± 21.86 ng/ml. CONCLUSION Our study demonstrated that PCOS is most commonly prevalent in young women of the reproductive age group which can lead to reproductive, metabolic, and oncological complications in the long term. LH/ FSH ratio was found to be significantly deranged indicating that PCOS should be diagnosed and treated early in the adolescent age group.
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Affiliation(s)
- Isha Rajbanshi
- Department of Clinical Biochemistry, Institute of Medicine, Tribhuvan University Teaching Hospital, Maharajgunj, Nepal
| | - Vijay Kumar Sharma
- Department of Clinical Biochemistry, Institute of Medicine, Tribhuvan University Teaching Hospital, Maharajgunj, Nepal
| | - Eans Tara Tuladhar
- Department of Clinical Biochemistry, Institute of Medicine, Tribhuvan University Teaching Hospital, Maharajgunj, Nepal
| | - Aseem Bhattarai
- Department of Clinical Biochemistry, Institute of Medicine, Tribhuvan University Teaching Hospital, Maharajgunj, Nepal
| | - Mithileshwar Raut
- Department of Clinical Biochemistry, Institute of Medicine, Tribhuvan University Teaching Hospital, Maharajgunj, Nepal
| | - Raju Kumar Dubey
- Department of Clinical Biochemistry, Institute of Medicine, Tribhuvan University Teaching Hospital, Maharajgunj, Nepal
| | - Poonam Koirala
- Department of Obstetrics and Gynecology, Institute of Medicine, Tribhuvan University Teaching Hospital, Maharajgunj, Nepal
| | - Apeksha Niraula
- Department of Clinical Biochemistry, Institute of Medicine, Tribhuvan University Teaching Hospital, Maharajgunj, Nepal.
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Liu C, Liu K, Zhao X, Zhu J, Liu Y, Hao L, Gao Y, Liu P. The Associations Between Alanine Aminotransferase and Other Biochemical Parameters in Lean PCOS. Reprod Sci 2023; 30:633-641. [PMID: 35864417 PMCID: PMC9988735 DOI: 10.1007/s43032-022-01030-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/30/2022] [Indexed: 11/26/2022]
Abstract
To explore the associations of alanine aminotransferase in lean women of polycystic ovary syndrome (PCOS) with other biochemical parameters and the potential risk factors. This is a retrospective cohort study with lean PCOS (n = 91) and healthy controls (n = 45); we reviewed the electrical records and databases of the PCOS patients in our infertility clinic between January 2019 and September 2021; independent t-test, linear correlation analysis, and multiple linear regression were used to explore the associations. Higher levels of luteinizing hormone, total testosterone, thyroid stimulating hormone, platelet count, lymphocyte count, homocysteine, alanine aminotransferase (ALT), and uric acid were identified in lean PCOS patients, while follicle-stimulating hormone level was lower in in lean PCOS as expected (P < 0.05). Of note, the linear correlation showed that BMI, total testosterone, white blood cell count, lymphocyte count, aspartate aminotransferase, and uric acid were positively associated with alanine aminotransferase (r = 0.232, 0.318, 0.218, 0.388, 0.602, 0.353 respectively, P < 0.05). After multiple linear regression was performed, total testosterone and aspartate aminotransferase were independently and positively correlated with alanine aminotransferase in lean PCOS (B = 0.251, 0.605 respectively, P < 0.05). Higher level of ALT was identified in the lean PCOS. BMI, white blood cell count, lymphocyte count, aspartate aminotransferase, uric acid, and total testosterone were positively correlated with ALT in lean PCOS. Total testosterone and aspartate aminotransferase were independently and positively associated with ALT in lean PCOS after multiple linear regression. There might exist a potential risk of afflicting liver impairment for the lean PCOS women in the earlier period. Early examination and intervention might be necessary to prevent or delay the progression of the liver disease as soon as the diagnosis of PCOS.
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Affiliation(s)
- Cai Liu
- Department of Infertility Clinic, Yulin City First Hospital, Yulin, China
| | - Kai Liu
- Department of Gynecology, Northwest Women and Children's Hospital, Xi'an, China
| | - Xiao Zhao
- Department of Intensive Care Unit, Xi'an Jiaotong University Second Affiliated Hospital, Xi'an, China
| | - Junhua Zhu
- Department of Infertility Clinic, Yulin City First Hospital, Yulin, China
| | - Yang Liu
- Department of Infertility Clinic, Yulin City First Hospital, Yulin, China
| | - Lina Hao
- Department of Infertility Clinic, Yulin City First Hospital, Yulin, China
| | - Yanyun Gao
- Department of Infertility Clinic, Yulin City First Hospital, Yulin, China
| | - Peng Liu
- Department of Hand and Foot Surgery, Yulin City First Hospital, Yulin, China.
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Feigl S, Obermayer-Pietsch B, Klaritsch P, Pregartner G, Herzog SA, Lerchbaum E, Trummer C, Pilz S, Kollmann M. Impact of Thyroid Function on Pregnancy and Neonatal Outcome in Women with and without PCOS. Biomedicines 2022; 10:biomedicines10040750. [PMID: 35453500 PMCID: PMC9025948 DOI: 10.3390/biomedicines10040750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Women with polycystic ovary syndrome (PCOS) are more prone to autoimmune thyroiditis, and both disorders lead to subfertility and pregnancy-related complications. The aim of this study was to investigate whether mothers with and without PCOS and their offspring have comparable thyroid parameters at term and how thyroid parameters are associated with perinatal outcome in this population. Methods: This cross-sectional observational study was performed in a single academic tertiary hospital in Austria. Seventy-nine pregnant women with PCOS and 354 pregnant women without PCOS were included. Blood samples were taken from the mother and cord blood at birth. Primary outcome parameters were maternal and neonatal thyroid parameters at delivery. Secondary outcome parameters were the composite complication rate per woman and per neonate. Results: Thyroid dysfunction was more prevalent among PCOS women (p < 0.001). At time of birth, free triiodothyronine (fT3) levels were significantly lower in PCOS than in non-PCOS women (p = 0.005). PCOS women and their neonates had significantly higher thyreoperoxidase antibody (TPO-AB) levels (p = 0.001). Women with elevated TPO-AB had a significantly higher prevalence of hypothyroidism (p < 0.001). There was a significant positive correlation between maternal and neonatal free thyroxine, fT3 and TPO-AB levels. There were no significant differences in thyroid parameters between women or neonates with or without complications. Conclusions: Our results demonstrate a higher prevalence of thyroid dysfunction and autoimmunity in PCOS women, supporting a common etiology of both disorders. We were not able to show an association between complication rate and thyroid parameters.
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Affiliation(s)
- Sarah Feigl
- Division of Obstetrics and Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Medical University of Graz, 8036 Graz, Austria; (S.F.); (P.K.)
| | - Barbara Obermayer-Pietsch
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria; (B.O.-P.); (E.L.); (C.T.); (S.P.)
| | - Philipp Klaritsch
- Division of Obstetrics and Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Medical University of Graz, 8036 Graz, Austria; (S.F.); (P.K.)
| | - Gudrun Pregartner
- Institute for Medical Informatics, Statistics and Documentation (IMI), Medical University of Graz, 8036 Graz, Austria; (G.P.); (S.A.H.)
| | - Sereina Annik Herzog
- Institute for Medical Informatics, Statistics and Documentation (IMI), Medical University of Graz, 8036 Graz, Austria; (G.P.); (S.A.H.)
| | - Elisabeth Lerchbaum
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria; (B.O.-P.); (E.L.); (C.T.); (S.P.)
| | - Christian Trummer
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria; (B.O.-P.); (E.L.); (C.T.); (S.P.)
| | - Stefan Pilz
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria; (B.O.-P.); (E.L.); (C.T.); (S.P.)
| | - Martina Kollmann
- Division of Obstetrics and Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Medical University of Graz, 8036 Graz, Austria; (S.F.); (P.K.)
- Correspondence:
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Association of Subclinical Hypothyroidism with Present and Absent Anti-Thyroid Antibodies with PCOS Phenotypes and Metabolic Profile. J Clin Med 2022; 11:jcm11061547. [PMID: 35329880 PMCID: PMC8948753 DOI: 10.3390/jcm11061547] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 03/08/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) and subclinical hypothyroidism (SCH) often coexist, but implications of the co-occurrence of two disorders have not yet been established. The objective is to conclude whether SCH with present or absent anti-thyroid antibodies (ATA) impacts on the PCOS phenotype and alters biochemical or clinical parameters. METHODS A retrospective cohort study was conducted in a tertiary reference center. Clinical and biochemical parameters of women with PCOS were analyzed. RESULTS A total of 367 women with PCOS were included in the study, 114 (31.1%) of whom were diagnosed with SCH and 16 (4.4%) with autoimmune thyroiditis (AIT). Among all parameters studied, the strongest relationship with SCH was confirmed for insulin resistance and dyslipidemia. SCH was an independent risk factor for insulin resistance. In SCH the additional presence of ATA did not exacerbate the metabolic disorders. There was no significant association of any PCOS phenotype with SCH, nor with the presence of circulating ATA. There was no significant difference in hormonal parameters and mFerriman-Gallwey scale score between women with PCOS with and without SCH. CONCLUSIONS SCH alters metabolic, but not hormonal, parameters in PCOS. The diagnosis of SCH does not exclude the diagnosis of PCOS. The potential effect of positive ATA was insignificant.
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Zhao H, Zhang Y, Ye J, Wei H, Huang Z, Ning X, Fu X. A Comparative Study on Insulin Secretion, Insulin Resistance and Thyroid Function in Patients with Polycystic Ovary Syndrome with and without Hashimoto's Thyroiditis. Diabetes Metab Syndr Obes 2021; 14:1817-1821. [PMID: 33953581 PMCID: PMC8089092 DOI: 10.2147/dmso.s300015] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 03/11/2021] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE The incidence of Hashimoto's thyroiditis (HT) in patients with polycystic ovary syndrome (PCOS) is significantly higher than in normal controls, and there is a risk of more severe metabolic symptoms when the two diseases occur together. This study compares insulin secretion, insulin resistance (IR) and thyroid function in patients with PCOS with and without HT. METHODS A total of 164 patients (52 patients with HT (HT+) and 112 patients without HT diagnosed PCOS at our hospital were enrolled for testing of oral glucose tolerance, insulin release, thyroid function, the presence of thyroglobulin and thyroid peroxidase antibodies, and blood lipid levels. RESULTS Patients with PCOS and HT had higher insulin secretion and IR levels than those without HT, while free thyroxine and thyrotropin levels were significantly lower. The ratio of free thyroxine to thyrotropin was higher in patients with HT. CONCLUSION HT may related with IR and relatively low thyroid function in patients with PCOS. Thus, thyroid function and autoimmune status in patients with PCOS should be evaluated in clinical practice.
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Affiliation(s)
- Hongli Zhao
- Department of Endocrinology, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, 510317, People’s Republic of China
| | - Ying Zhang
- Department of Endocrinology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, People’s Republic of China
| | - Jianhong Ye
- Department of Endocrinology, Foshan Hospital of Traditional Chinese Medicine, Foshan, 528000, People’s Republic of China
- Correspondence: Jianhong Ye Department of Endocrinology, Foshan Hospital of Traditional Chinese Medicine, No. 6, Qinren Road, Chancheng District, Foshan, Guangdong Province, 528000, People’s Republic of ChinaTel/Fax +86 0757-83066101 Email
| | - Hongjiang Wei
- Outpatient Department, Guangdong Second Provincial General Hospital, Guangzhou, 510317, People’s Republic of China
| | - Zhengping Huang
- Department of Rheumatology and Immunology, Guangdong Second Provincial General Hospital, Guangzhou, 510317, People’s Republic of China
| | - Xiaoyan Ning
- Department of Gastroenterology, Guangdong Second Provincial General Hospital, Guangzhou, 510317, People’s Republic of China
| | - Xiaoying Fu
- Department of Endocrinology, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, 510317, People’s Republic of China
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