Sinha Uma, Sinharay Keshab, Saha Sudipta, Longkumer T Amenla, Baul Shuvra Neel, Pal Salil Kuamr
Department of Medicine, Nilratan Sircar Medical College, Kolkata, West Bengal, India.
Indian J Endocrinol Metab. 2013 Mar;17(2):304-9. doi: 10.4103/2230-8210.109714.
Polycystic ovarian syndrome (PCOS), the most common endocrinopathy of women in the reproductive age group seems to be adversely affected by associated thyroid dysfunction. Both pose independent risks of ovarian failure and pregnancy related complications.
The present study from Eastern India is, therefore, aimed to investigate the prevalence and etiology of different thyroid disorders in PCOS subjects.
Cross-sectional hospital based survey-single centre observational case-control study.
This prospective single-center study recruited 106 female patients with hypertrichosis and menstrual abnormality among which 80 patients were defined as having PCOS according to the revised 2003 Rotterdam criteria and comprised the study population. Another 80 age-matched female subjects were studied as the control population. Thyroid function and morphology were evaluated by measurement of serum thyroid stimulating hormone (TSH), free thyroxine levels (free T3 and free T4), anti-thyroperoxidase antibody (anti-TPO Ab), clinical examination and ultrasound (USG) of thyroid gland.
It was done by Student's t-test and Chi-square test using appropriate software (SPSS version 19).
This case-control study revealed statistically significant higher prevalence of autoimmune thyroiditis, detected in 18 patients (22.5% vs. 1.25% of control) as evidenced by raised anti-TPO antibody levels (means 28.037 ± 9.138 and 25.72 ± 8.27 respectively; P = 0.035). PCOS patients were found to have higher mean TSH level than that of the control group (4.547 ± 2.66 and 2.67 ± 3.11 respectively; P value < 0.05). There was high prevalence of goiter among PCOS patients (27.5% vs. 7.5% of control, P value > 0.001). On thyroid USG a significantly higher percentage of PCOS patients (12.5%; controls 2.5%) had hypoechoic USG pattern also compatible with the diagnosis of autoimmune thyroiditis.
High prevalence of thyroid disorders in PCOS patients thus points towards the importance of early correction of hypothyroidism in the management of infertility associated with PCOS.
多囊卵巢综合征（PCOS）是育龄期女性最常见的内分泌疾病，似乎会受到相关甲状腺功能障碍的不利影响。两者都独立增加了卵巢功能衰竭和妊娠相关并发症的风险。
因此，这项来自印度东部的研究旨在调查PCOS患者中不同甲状腺疾病的患病率和病因。
基于医院的横断面调查——单中心观察性病例对照研究。
这项前瞻性单中心研究招募了106名多毛症和月经异常的女性患者，其中80名患者根据2003年修订的鹿特丹标准被定义为患有PCOS，构成研究人群。另外80名年龄匹配的女性受试者作为对照人群进行研究。通过测量血清促甲状腺激素（TSH）、游离甲状腺素水平（游离T3和游离T4）、抗甲状腺过氧化物酶抗体（抗TPO Ab）、临床检查和甲状腺超声（USG）来评估甲状腺功能和形态。
使用适当软件（SPSS 19版）通过学生t检验和卡方检验进行分析。
这项病例对照研究显示，自身免疫性甲状腺炎的患病率在统计学上显著更高，18名患者中检测到（22.5%对比对照组的1.25%），抗TPO抗体水平升高证明了这一点（均值分别为28.037±9.138和25.72±8.27；P = 0.035）。发现PCOS患者的平均TSH水平高于对照组（分别为4.547±2.66和2.67±3.11；P值<0.05）。PCOS患者中甲状腺肿的患病率很高（27.5%对比对照组的7.5%，P值>0.001）。在甲状腺超声检查中，PCOS患者中出现低回声超声模式的比例显著更高（12.5%；对照组为2.5%），这也符合自身免疫性甲状腺炎的诊断。
PCOS患者中甲状腺疾病的高患病率表明，在与PCOS相关的不孕症管理中，早期纠正甲状腺功能减退具有重要意义。
