Kamrul-Hasan Abm, Aalpona Fatema Tuz Zahura, Selim Shahjada
Department of Endocrinology, Mymensingh Medical College, Mymensingh, Bangladesh.
Outpatient Department, Gynaecology and Obstetrics, Mymensingh Medical College Hospital, Mymensingh, Bangladesh.
Eur Endocrinol. 2020 Oct;16(2):156-160. doi: 10.17925/EE.2020.16.2.156. Epub 2020 Oct 6.
Separately, polycystic ovary syndrome (PCOS) and subclinical hypothyroidism (SCH) exert adverse effects on several reproductive and metabolic parameters; however, in conjunction, their effects are unclear. This study evaluated the impact of SCH on reproductive and metabolic parameters in women with PCOS.
In this cross-sectional study, women with newly diagnosed PCOS were evaluated. Data on their clinical presentation and anthropometric measurements were recorded, in addition to oral glucose tolerance test, fasting lipid profile, serum thyroid-stimulating hormone (TSH), free thyroxine (FT4) and anti-thyroid peroxidase (anti-TPO).
Four hundred and sixty-five women, aged 12-40 years, with PCOS were included in this study; 10.8% of them had SCH and 18.3% were positive for anti-TPO. All participants had statistically similar mean age, body mass index (BMI), waist circumference, systolic blood pressure (BP) and diastolic BP. A similar number of participants in both the euthyroid PCOS and PCOS-SCH groups had menstrual irregularity, acne, subfertility, a first-degree family member with thyroid dysfunction, acanthosis nigricans and elevated BP. Participants with SCH-PCOS had a lower modified Ferriman-Gallwey score and hirsutism frequency, though serum total testosterone levels were similar in the two groups. More subjects in the SCH group were overweight/obese, and had central obesity and goiter compared to the euthyroid group. Blood glucose, lipids and prolactin levels were similar between the two groups; the frequencies of dysglycaemia and dyslipidaemia were also similar. A higher frequency of metabolic syndrome was observed in the SCH group, though the difference was not statistically significant (p=0.098).
In women with PCOS, the presence of SCH does not amplify the risk of metabolic and reproductive dysfunctions.
多囊卵巢综合征（PCOS）和亚临床甲状腺功能减退症（SCH）分别对多个生殖和代谢参数产生不利影响；然而，二者共同作用时，其影响尚不清楚。本研究评估了SCH对PCOS女性生殖和代谢参数的影响。
在这项横断面研究中，对新诊断为PCOS的女性进行了评估。记录了她们的临床表现和人体测量数据，此外还进行了口服葡萄糖耐量试验、空腹血脂谱、血清促甲状腺激素（TSH）、游离甲状腺素（FT4）和抗甲状腺过氧化物酶（抗TPO）检测。
本研究纳入了465名年龄在12至40岁之间的PCOS女性；其中10.8%患有SCH，18.3%抗TPO呈阳性。所有参与者的平均年龄、体重指数（BMI）、腰围、收缩压（BP）和舒张压在统计学上相似。甲状腺功能正常的PCOS组和PCOS-SCH组中，月经不规律、痤疮、生育力低下、有甲状腺功能障碍的一级家庭成员、黑棘皮病和血压升高的参与者数量相似。SCH-PCOS参与者的改良Ferriman-Gallwey评分和多毛症发生率较低，尽管两组的血清总睾酮水平相似。与甲状腺功能正常组相比，SCH组超重/肥胖、中心性肥胖和甲状腺肿的受试者更多。两组之间的血糖、血脂和催乳素水平相似；血糖异常和血脂异常的发生率也相似。SCH组代谢综合征的发生率较高，尽管差异无统计学意义（p=0.098）。
在PCOS女性中，SCH的存在不会增加代谢和生殖功能障碍的风险。
