Ulrich Jan, Goerges Julia, Keck Christoph, Müller-Wieland Dirk, Diederich Sven, Janssen Onno Eilard
Endokrinologikum Hamburg, Lornsenstraße 4-6; Hamburg, Germany.
Asklepios Klinik St. Georg, Allgemeine Innere Medizin, Lohmühlenstraße 5; Hamburg, Germany.
Exp Clin Endocrinol Diabetes. 2018 Apr;126(4):198-204. doi: 10.1055/s-0043-110480. Epub 2018 Mar 5.
Autoimmune thyroiditis (AIT) has been found to be associated with polycystic ovary syndrome (PCOS). The aim of this retrospective cohort study using data from a fertility clinic, with patients recruited from 2009 to 2010, was to confirm the higher prevalence of AIT in PCOS and to evaluate the impact of AIT on reproductive and metabolic parameters of PCOS patients.
Patients comprised 827 PCOS subjects seen for reproductive or metabolic complaints. Patients presenting primarily for thyroid problems were excluded. All patients were tested for the presence of AIT by laboratory testing and thyroid ultrasound. The impact of AIT on PCOS was evaluated by determination of reproductive and metabolic parameters.
Patients with PCOS and AIT as compared to those only with PCOS, had a lower prevalence of elevated testosterone (45 vs. 61%; p=0,0001), free androgen index (5,96±5,41 vs. 7,02±7,6; p<0,001) and hyperandrogenemia (66 vs. 78%; p<0,001). Also testosterone levels were lower in PCOS patients with AIT (0,50±0,30 vs. 0,63±0,71; p=0,0006). Consequently, in these patients, hirsutism was less frequent (51 vs. 66%; p=0,0021). There was no difference in the prevalence of acne, alopecia, a-/ or oligomenorrhea or PCO-morphology in the two patient groups. Patients with PCOS and AIT were more obese by 2 kg/m² BMI on average. A higher BMI correlated with a higher TSH value, although all patients were euthyroid.
AIT is more prevalent in PCOS than in controls. PCOS patients with AIT have less severe hyperandrogenemia and hyperandrogenism but are likely to suffer from an elevated metabolic risk.
自身免疫性甲状腺炎（AIT）已被发现与多囊卵巢综合征（PCOS）相关。本项回顾性队列研究利用一家生育诊所2009年至2010年招募患者的数据，旨在证实PCOS患者中AIT的患病率更高，并评估AIT对PCOS患者生殖和代谢参数的影响。
患者包括827名因生殖或代谢问题就诊的PCOS受试者。主要因甲状腺问题就诊的患者被排除。所有患者均通过实验室检测和甲状腺超声检查AIT的存在情况。通过测定生殖和代谢参数来评估AIT对PCOS的影响。
与仅患有PCOS的患者相比，患有PCOS和AIT的患者睾酮升高的患病率较低（45%对61%；p=0.0001），游离雄激素指数较低（5.96±5.41对7.02±7.6；p<0.001），高雄激素血症患病率较低（66%对78%；p<0.001）。此外，患有AIT的PCOS患者的睾酮水平也较低（0.50±0.30对0.63±0.71；p=0.0006）。因此，在这些患者中，多毛症的发生率较低（51%对66%；p=0.0021）。两组患者在痤疮、脱发、月经过少或稀发或PCO形态的患病率方面没有差异。患有PCOS和AIT的患者平均肥胖程度高2kg/m²。尽管所有患者甲状腺功能正常，但BMI越高，促甲状腺激素（TSH）值越高。
AIT在PCOS患者中的患病率高于对照组。患有AIT的PCOS患者高雄激素血症和高雄激素症状较轻，但可能代谢风险升高。
