Ach Taieb, Dhaffar Rim, Ben Abdessalem Fatma, Saafi Wiem, Halloul Imen, ElFekih Hamza, Saad Ghada, Hasni Yosra
Faculty of Medicine of Sousse, University of Sousse, Tunisia.
Department of Endocrinology, University Hospital of Farhat Hached Sousse, Tunisia.
Clin Med Insights Endocrinol Diabetes. 2025 Jun 3;18:11795514251343678. doi: 10.1177/11795514251343678. eCollection 2025.
Polycystic ovary syndrome (PCOS) is a complex condition linked to long-term health risks such as cardiovascular disease, type 2 diabetes, and metabolic syndrome. Subclinical hypothyroidism (SCH) shares overlapping symptoms with PCOS, but their relationship remains debated. SCH prevalence in PCOS patients and its impact on cardiovascular and metabolic health is debated and thus warrants further research. This research examined the association between SCH and PCOS in a Tunisian clinical-based population.
We conducted a prospective cross-sectional study of 161 PCOS patients and 75 age-matched controls recruited from 2023 to 2024. All participants underwent thyroid function testing, metabolic profiling, and hormonal assays. Statistical analyses included Mann-Whitney , Kruskal-Wallis, and chi-square tests, with age/BMI-adjusted linear regression models.
Among 236 participants (161 PCOS, 75 controls), SCH prevalence was higher in PCOS patients (14.9%) compared to controls (5.3%, = .048). Adjusted for age and BMI, median TSH levels were higher in the PCOS group (2.2 mIU/L vs 1.75 mIU/L, = .006), while FT4 levels were lower (14.26 pmol/L vs 15.26 pmol/L, = .007). Positive TPOAb prevalence was higher in PCOS (12.4% vs 2.7%, = .049). TSH levels varied across PCOS phenotypes ( = .003), with Phenotypes A and B showing higher levels than Phenotype C (A > C, = .019; B > C, < .001). SCH was highest in Phenotype A. SCH in PCOS was associated with impaired glucose tolerance ( = .011), higher blood fasting glucose ( = .033), higher total cholesterol ( = .022), and hypertriglyceridemia ( = .018).
SCH is more prevalent in PCOS and may worsen insulin resistance and dyslipidemia. Addressing thyroid dysfunction in PCOS patients may be beneficial for more effective management strategies, ultimately improving reproductive, metabolic, and cardiovascular outcomes for affected women.
多囊卵巢综合征（PCOS）是一种复杂的病症，与心血管疾病、2型糖尿病和代谢综合征等长期健康风险相关。亚临床甲状腺功能减退症（SCH）与PCOS有重叠症状，但其关系仍存在争议。PCOS患者中SCH的患病率及其对心血管和代谢健康的影响存在争议，因此值得进一步研究。本研究在突尼斯一个以临床为基础的人群中探讨了SCH与PCOS之间的关联。
我们对2023年至2024年招募的161例PCOS患者和75例年龄匹配的对照进行了一项前瞻性横断面研究。所有参与者均接受了甲状腺功能测试、代谢谱分析和激素检测。统计分析包括曼-惠特尼检验、克鲁斯卡尔-沃利斯检验和卡方检验，并采用年龄/体重指数调整的线性回归模型。
在236名参与者（161例PCOS患者，75例对照）中，PCOS患者的SCH患病率（14.9%）高于对照组（5.3%，P = 0.048）。经年龄和体重指数调整后，PCOS组的促甲状腺激素（TSH）中位数水平较高（2.2 mIU/L对1.75 mIU/L，P = 0.006），而游离甲状腺素（FT4）水平较低（14.26 pmol/L对15.26 pmol/L，P = 0.007）。PCOS患者中甲状腺过氧化物酶抗体（TPOAb）阳性率较高（12.4%对2.7%，P = 0.049）。TSH水平在不同PCOS表型中有所不同（P = 0.003），A和B表型的TSH水平高于C表型（A>C，P = 0.019；B>C，P<;0.001）。A表型的SCH最高。PCOS中的SCH与糖耐量受损（P = 0.011）、空腹血糖升高（P = 0.033）、总胆固醇升高（P = 0.022）和高甘油三酯血症（P = 0.018）相关。
SCH在PCOS中更为普遍，可能会加重胰岛素抵抗和血脂异常。解决PCOS患者的甲状腺功能障碍可能有利于制定更有效的管理策略，最终改善受影响女性的生殖、代谢和心血管结局。
