Abstract
AimThe correlation of subclinical hypothyroidism (SCH) and polycystic ovary syndrome (PCOS) is a still insufficiently explored entity. The aim of this study was to determine the correlation between SCH and PCOS along with the impact of SCH on metabolic and hormonal parameters in women with PCOS.MethodologyThis cross-sectional study was conducted at the Gynecology Outpatient Department of Ziauddin Hospital Kemari, Karachi, Pakistan, from June 2019 to December 2019. A total of 90 diagnosed cases of PCOS were enrolled in the study. A non-probability consecutive sampling technique was used. After taking informed consent, participants were evaluated through clinical interviews, a questionnaire, and anthropometric measurements. The participants underwent the following assessments, i.e., transabdominal ultrasonography, hormonal profile (free testosterone, follicle-stimulating hormone, luteinizing hormone), and fasting blood sugar. Participants were divided into two groups based on thyroid-stimulating hormone (TSH) into the euthyroid group and subclinical hypothyroid (SCH) group. The Mann-Whitney test was used for comparing the two groups.ResultsOur results showed a significant difference in weight, body mass index (BMI), insulin, homeostatic model assessment of insulin resistance (HOMA-IR), and TSH were found in the SCH group as compared to the euthyroid group. A significant correlation of TSH with waist-hip ratio (WHR), weight, body mass index (BMI), insulin, and the homeostatic model assessment of insulin resistance (HOMA-IR) in PCOS patients.ConclusionThis study showed a significant correlation of subclinical hypothyroidism with polycystic ovary syndrome. We found subclinical hypothyroidism may aggravate the insulin resistance; therefore, PCOS patients must be screened with a thyroid profile.
Highlights
Polycystic ovary syndrome (PCOS) is an endocrine disease of females that commonly presents during reproductive life [1]
Our results showed a significant difference in weight, body mass index (BMI), insulin, homeostatic model assessment of insulin resistance (HOMA-IR), and thyroid-stimulating hormone (TSH) were found in the subclinical hypothyroidism (SCH) group as compared to the euthyroid group
This cutoff value was chosen based on the American Thyroid Association (ATA) consensus guideline (Recommendation 20) that recommends treatment of SCH due to higher reported clinical pregnancy rates and lower miscarriage rates after assisted reproductive treatment (ART) when TSH levels are maintained < 2.5 mIU/L [14]
Summary
Polycystic ovary syndrome (PCOS) is an endocrine disease of females that commonly presents during reproductive life [1] The pathophysiology of this disease mainly includes chronic anovulation, hyperandrogenemia, and insulin resistance (IR) which may present clinically as abnormal uterine bleeding, hirsutism, infertility, etc. This syndrome is diagnosed by the presence of two of the following three criteria: oligo- or anovulation, clinical and/or biochemical hyperandrogenism, and a finding of polycystic ovaries by ultrasound with the exclusion of other causes [2]. SCH represents a milder form of hypothyroidism that does not present with overt clinical symptoms but may contribute to subfertility and adverse pregnancy outcomes It is characterized biochemically by an elevated thyroid-stimulating hormone (TSH) level and normal free thyroxine (FT4). The latter is considered a more appropriate cutoff level for patients with infertility or
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