Vryonidou Andromachi, Mizamtsidi Maria, Palioura Eleni, Kalogeris Nikolaos, Vassilatou Evangeline, Ioannidis Dimitrios, Loi Vicky, Paschou Stavroula A
Department of Endocrinology and Diabetes, Hellenic Red Cross Hospital, Athens, Greece.
Endocrine Unit, "Hygeia" Hospital, Athens, Greece.
Endocrine. 2025 May;88(2):529-536. doi: 10.1007/s12020-025-04181-3. Epub 2025 Jan 30.
Several studies suggest a linkage between PCOS and autoimmunity with a high frequency of chronic autoimmune thyroiditis (AIT) reported in PCOS patients, however, this subject remains controversial. The aim of this study was to investigate the prevalence of AIT in PCOS women and identify parameters that would serve as independent predictors of AIT.
Two hundred fifty seven (257) PCOS patients according to the NIH criteria and one hundred forty three (143) controls, women with normal menstrual cycles and without clinical or biochemical hyperandrogenism, were recruited for the study. Anthropometric characteristics and a complete family history for AIT were recorded. Thyroid hormones, antithyroid antibodies, androgen, glucose and insulin levels were measured. Thyroid gland structure was evaluated by ultrasound scan.
Patients and controls did not differ in age, BMI as well as genetic predisposition for AIT (p > 0.05). Women with PCOS presented higher levels of androgens and HOMA-IR index, as expected. AIT prevalence did not differ between women with PCOS and controls (4.8 vs 9.3%, p = 0.13). However, the subgroup of PCOS patients with AIT presented a significantly stronger predisposition for AIT (33.3 vs 4.7%, p = 0.004) compared to patients without AIT. In a multivariate regression model, a positive family history of AIT was proved to be the strongest independent predictor of AIT in the PCOS group (OR 7.06, 95% CI 1.04-47.79, R = 0.39).
The prevalence of AIT in the PCOS patients does not differ from the general population when family predisposition to AIT is taken into account.
多项研究表明多囊卵巢综合征（PCOS）与自身免疫之间存在联系，报道称PCOS患者中慢性自身免疫性甲状腺炎（AIT）的发生率较高，然而，这一问题仍存在争议。本研究的目的是调查PCOS女性中AIT的患病率，并确定可作为AIT独立预测指标的参数。
根据美国国立卫生研究院（NIH）标准招募了257例PCOS患者和143例对照者，对照者为月经周期正常且无临床或生化高雄激素血症的女性。记录人体测量特征和AIT的完整家族史。测量甲状腺激素、抗甲状腺抗体、雄激素、血糖和胰岛素水平。通过超声扫描评估甲状腺结构。
患者和对照者在年龄、体重指数以及AIT的遗传易感性方面无差异（p>0.05）。正如预期的那样，PCOS女性的雄激素水平和HOMA-IR指数较高。PCOS女性和对照者之间的AIT患病率无差异（4.8%对9.3%，p=0.13）。然而，与无AIT的PCOS患者相比，患有AIT的PCOS患者亚组对AIT的易感性明显更强（33.3%对4.7%，p=0.004）。在多变量回归模型中，AIT的阳性家族史被证明是PCOS组中AIT最强的独立预测指标（OR 7.06，95%CI 1.04-47.79，R=0.39）。
考虑到AIT的家族易感性，PCOS患者中AIT的患病率与普通人群无差异。
