Gawron Iwona, Baran Rafal, Jach Robert
Jagiellonian University Medical College, Faculty of Medicine, Chair of Gynecology and Obstetrics, Kopernika 23, 31-501, Krakow, Poland.
Endocrine. 2025 Apr;88(1):330-347. doi: 10.1007/s12020-024-04151-1. Epub 2025 Jan 2.
To compare ovarian function measures in euthyroid women with normogonadotropic anovulation in subclinical hypothyroidism (SCH) or thyroid autoimmunity (TAI) to those without thyroid dysfunction.
A prospective open-label cohort study analyzed anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone, estradiol and testosterone concentrations, ovarian volume, and polycystic ovarian morphology (PCOM) incidence between women with and without SCH or TAI in two study arms: polycystic ovary syndrome (PCOS) and hypothalamic-pituitary-ovarian dysfunction (HPOD).
The prevalence of circulating thyroid peroxidase antibodies (TPOAb) was higher in the PCOS compared to the HPOD arm (p = 0.006). No significant differences in the measured parameters were observed based on SCH or TAI status across the entire cohort or individual study arms, except for phenotype D of PCOS, where a greater volume (p = 0.031) and higher incidence of physiological lesions (p = 0.047) in the left ovary were noted in SCH, and phenotype A, where LH concentrations (p = 0.038) were significantly higher in women without TAI. In the PCOS arm, thyroglobulin antibodies (TGAb) concentration correlated negatively with FSH (p = 0.049) and positively with testosterone (p = 0.012) concentrations, while in the HPOD arm, TPOAb and FSH concentrations were negatively correlated (p = 0.028).
No clinically significant impact of SCH on ovarian function measures was demonstrated. Regarding TAI, significant correlations with still uncertain clinical significance were observed with FSH concentrations, both in PCOS and in HPOD. In view of the obtained results, the benefits of thyroxine supplementation to address menstrual irregularities and improve obstetric outcomes in the examined conditions, require support with clinical evidence.
比较亚临床甲状腺功能减退症（SCH）或甲状腺自身免疫（TAI）伴正常促性腺激素性无排卵的甲状腺功能正常女性与无甲状腺功能障碍女性的卵巢功能指标。
一项前瞻性开放标签队列研究分析了两个研究组（多囊卵巢综合征（PCOS）和下丘脑 - 垂体 - 卵巢功能障碍（HPOD））中有无SCH或TAI的女性之间的抗苗勒管激素（AMH）、促卵泡生成素（FSH）、促黄体生成素、雌二醇和睾酮浓度、卵巢体积以及多囊卵巢形态（PCOM）发生率。
与HPOD组相比，PCOS组中循环甲状腺过氧化物酶抗体（TPOAb）的患病率更高（p = 0.006）。在整个队列或各个研究组中，基于SCH或TAI状态，所测量的参数均未观察到显著差异，但PCOS的D型除外，其中SCH患者左卵巢体积更大（p = 0.031）且生理性病变发生率更高（p = 0.047），以及A 型，其中无TAI的女性促黄体生成素浓度显著更高（p = 0.038）。在PCOS组中，甲状腺球蛋白抗体（TGAb）浓度与FSH呈负相关（p = 0.049），与睾酮浓度呈正相关（p = 0.012），而在HPOD组中，TPOAb与FSH浓度呈负相关（p = 0.028）。
未证明SCH对卵巢功能指标有临床显著影响。关于TAI，在PCOS和HPOD中均观察到与FSH浓度存在显著相关性，但其临床意义仍不确定。鉴于所获得的结果，在这些情况下补充甲状腺素以解决月经不规律和改善产科结局的益处，需要临床证据的支持。
