Yue Fangzhi, Zhang Dongmei, Gong Fei, Zhang Li, Sun Zhixiang, Lei Minxiang
Department of Endocrinology, Xiangya Hospital, Central South University, Changsha 410008, China.
Reproductive and Genetic Hospital of Citic-Xiangya, Changsha 410078, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2017 Aug 28;42(8):940-946. doi: 10.11817/j.issn.1672-7347.2017.08.011.
To explore associations of subclinical hypothyroidism (SCH) with endocrine metabolic characteristics in women with polycystic ovary syndrome (PCOS). Methods: A total of 321 women who were newly diagnosed as PCOS were recruited from two endocrine outpatient clinics. The diagnosis of PCOS was established according to the 2003 Rotterdam consensus criteria. Thyroid function was examined by chemiluminescent immunoassay. Patients who had normal free thyroxine (FT4) were divided into different SCH subgroups according to two thyroid stimulating hormone (TSH) cutoff points (4.2 and 2.5 mU/L). Endocrine metabolic characteristics in different subgroups were compared and analyzed. Results: In PCOS women with normal FT4, the patients with TSH≥4.2 mU/L had higher prolactin (PRL), luteinizing hormone-to-follicle stimulating hormone ratio, and visceral adipose index (all P<0.05). There were trends toward an increase in triglyceride (P=0.085) and a decrease in high-density lipoprotein cholesterol (HDL-C) (P=0.060) in the patients with TSH≥4.2 mU/L compared with that in the patients with TSH<4.2 mU/L. Also in PCOS women with normal FT4, the patients with TSH≥2.5 mU/L had higher body mass index, PRL, triglyceride, visceral adipose index and lower HDL-C in comparison of that in the patients with TSH<2.5 mU/L (all P<0.05). Conclusion: SCH is associated with more severe endocrine abnormality, dyslipidemia, and visceral obesity in PCOS women. PCOS women with normal FT4 and endocrine metabolic characteristics are more prone to be different between the SCH group and the euthyroid group when setting 2.5 mU/L as a TSH cutoff for SCH, indicating that 2.5 mU/L is a good TSH cutoff for SCH in PCOS women.
探讨多囊卵巢综合征（PCOS）女性亚临床甲状腺功能减退（SCH）与内分泌代谢特征之间的关联。方法：从两家内分泌门诊招募了321例新诊断为PCOS的女性。PCOS的诊断依据2003年鹿特丹共识标准确定。采用化学发光免疫分析法检测甲状腺功能。游离甲状腺素（FT4）正常的患者根据两个促甲状腺激素（TSH）切点（4.2和2.5 mU/L）分为不同的SCH亚组。比较并分析不同亚组的内分泌代谢特征。结果：在FT4正常的PCOS女性中，TSH≥4.2 mU/L的患者泌乳素（PRL）、黄体生成素与卵泡刺激素比值及内脏脂肪指数更高（均P<0.05）。与TSH<4.2 mU/L的患者相比，TSH≥4.2 mU/L的患者甘油三酯有升高趋势（P=0.085），高密度脂蛋白胆固醇（HDL-C）有降低趋势（P=0.060）。同样在FT4正常的PCOS女性中，与TSH<2.5 mU/L的患者相比，TSH≥2.5 mU/L的患者体重指数、PRL、甘油三酯、内脏脂肪指数更高，HDL-C更低（均P<0.05）。结论：SCH与PCOS女性更严重的内分泌异常、血脂异常和内脏肥胖有关。以2.5 mU/L作为SCH的TSH切点时，FT4正常且有内分泌代谢特征的PCOS女性在SCH组和甲状腺功能正常组之间更容易出现差异，表明2.5 mU/L是PCOS女性SCH的良好TSH切点。
