Akbas Feray, Teke Zeynep Banu, Cavdar Vahit Can, Zerdali Hasan
Department of Internal Medicine, Istanbul Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
Metab Syndr Relat Disord. 2025 May;23(4):211-216. doi: 10.1089/met.2024.0181. Epub 2024 Dec 10.
Hashimoto's thyroiditis is a common endocrinological disorder that often coexists with obesity. Thyroid hormones interact with the regulation of sex steroids, and thyroid autoimmunity has a negative impact on female fertility. There are studies showing when euthyroid state is achieved with hormone replacement therapy (HRT), the reproductive hormone profile is improved but they usually compare the reproductive hormones before and after HRT in the same individuals. Studies comparing patients with Hashimoto's thyroiditis in an euthyroid state receiving HRT with individuals having normal thyroid function are limited. Here, it was aimed to search the impact of euthyroid Hashimoto's thyroiditis on reproductive hormone profile in women living with obesity. Sixty-one randomly selected female patients with Hashimoto's thyroiditis were included as the case group and 60 patients without Hashimoto's thyroiditis were included as the control group, from our obesity center. The case group included patients who had menstrual cycles and were euthyroid under l-thyroxine treatment for at least 6 months. Data on weight, height, body mass index (BMI), waist circumference (WC), free thyroxine (fT4), thyroid stimulating hormone (TSH), thyroid peroxidase antibody (anti-TPO), cortisol, insulin, prolactin (PRL), follicular stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E), progesterone (prog), testosterone (T), and dehydroepiandrosterone sulfate (DHEAS) levels, l-thyroxine treatment dosage (for case group), and accompanying diseases were recorded. The results were evaluated using SPSS. A total of 121 patients were included in the study. Mean age was 41.8 ± 8.5 years in case and 38.6 ± 8.9 years in control group. There was no significant difference in weight, height, BMI, WC, or accompanying diseases between Hashimoto's thyroiditis and control group. fT4, anti-TPO, cortisol levels were higher in Hashimoto's thyroiditis group when compared with control group, but there was no significant difference for TSH, insulin, FSH, LH, E, prog, T, DHEAS, or PRL. In women living with obesity, it is important to screen for Hashimoto's thyroiditis and achieve euthyroidism through effective LT4 treatment to promote a healthy reproductive system and improve fertility rates.
桥本甲状腺炎是一种常见的内分泌疾病,常与肥胖并存。甲状腺激素与性类固醇的调节相互作用,甲状腺自身免疫对女性生育能力有负面影响。有研究表明,当通过激素替代疗法(HRT)实现甲状腺功能正常状态时,生殖激素水平会得到改善,但这些研究通常比较的是同一患者在HRT前后的生殖激素水平。比较处于甲状腺功能正常状态且接受HRT的桥本甲状腺炎患者与甲状腺功能正常个体的研究有限。在此,旨在探究甲状腺功能正常的桥本甲状腺炎对肥胖女性生殖激素水平的影响。从我们的肥胖中心随机选取61例桥本甲状腺炎女性患者作为病例组,60例无桥本甲状腺炎的患者作为对照组。病例组包括月经周期正常且接受左甲状腺素治疗至少6个月后甲状腺功能正常的患者。记录体重、身高、体重指数(BMI)、腰围(WC)、游离甲状腺素(fT4)、促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(抗-TPO)、皮质醇、胰岛素、催乳素(PRL)、卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E)、孕酮(prog)、睾酮(T)和硫酸脱氢表雄酮(DHEAS)水平、左甲状腺素治疗剂量(病例组)以及伴随疾病。使用SPSS对结果进行评估。本研究共纳入121例患者。病例组的平均年龄为41.8±8.5岁,对照组为38.6±8.9岁。桥本甲状腺炎组与对照组在体重、身高、BMI、WC或伴随疾病方面无显著差异。与对照组相比,桥本甲状腺炎组的fT4、抗-TPO、皮质醇水平较高,但TSH、胰岛素、FSH、LH、E、prog、T、DHEAS或PRL无显著差异。对于肥胖女性,筛查桥本甲状腺炎并通过有效的左甲状腺素治疗实现甲状腺功能正常,对于促进健康的生殖系统和提高生育率很重要。