Abstract
BackgroundOvarian reserve, vital for reproductive function, can be adversely affected by thyroid diseases. Despite alternations of thyroid hormones with ageing, data on interactions between the overtime trend of thyroid functions and ovarian reserve status has rarely been reported. We aimed to examine the overtime trend of thyroid hormones, thyroid peroxidase antibody (TPO Ab) and their associations with ovarian reserve status, identified by levels of age specific anti-mullerian hormone (AMH) in reproductive aged women, who participated in 12-year cohort of Tehran Thyroid Study (TTS).MethodsReproductive age women(n = 775) without any thyroid disease or ovarian dysfunction were selected from the Tehran Thyroid Study cohort. Participants were divided into four age specific AMH quartiles (Q1-Q4), Q1, the lowest and Q4, the highest. AMH was measured at the initiation of study and thyroid stimulating hormone (TSH), free T4 (FT4), and TPO Ab were measured at baseline and at three follow up visits.ResultsAt baseline, there was no statistically significant difference in thyroid hormones between women of the four quartiles, although TPO Ab levels were higher in women of Q1. During the follow ups, FT4 was decreased in all quartiles (p < 0.05), whereas TPO Ab increased in Q1 (p = 0.02). Odds ratio of overall TPO Ab positivity in women of Q1 was 2.08 fold higher than those in Q4. (OR: 2.08, 95%CI: 1.16, 3.72; p = 0.01).ConclusionWomen with the lowest ovarian reserves had higher levels of TPO Ab, with a positive trend of this antibody overtime in comparison to other quartiles, indicating that this group may be at a higher risk of hypothyroidism over time.
Highlights
Ovarian reserve, vital for reproductive function, can be adversely affected by thyroid diseases
Ovarian reserve is vital for reproductive function, and women with reduced ovarian follicles are at an increased risk of premature ovarian failure (POF) [1]
According to generalized estimation equation (GEE) analysis (Table 3), after adjustment for Body Mass Index (BMI), parity, smoking status, and educational level, there was a statistically significant annual decrease in mean changes of free T4 (FT4) in all anti-Müllerian hormone (AMH) quartiles; these decreases were [− 0.28(95%CI: -0.43, − 0.1); p < 0.001], [− 0.18, (95%CI: -0.34, − 0.01); p = 0.02], [− 0.25 (95%CI: -0.42, − 0.10); p = 0.001], [− 0.25 (95%CI: -0.41, − 0.09)
Summary
Vital for reproductive function, can be adversely affected by thyroid diseases. Despite alternations of thyroid hormones with ageing, data on interactions between the overtime trend of thyroid functions and ovarian reserve status has rarely been reported. We aimed to examine the overtime trend of thyroid hormones, thyroid peroxidase antibody (TPO Ab) and their associations with ovarian reserve status, identified by levels of age specific anti-mullerian hormone (AMH) in reproductive aged women, who participated in 12-year cohort of Tehran Thyroid Study (TTS). In a cross sectional study of 5000 Belgian women (mean age: 32.0, SD: 5.5 years), there were no significant association, between ovarian reserve, thyroid hormones and thyroid autoimmunity [9]. We aimed to assess the trend of changes in thyroid hormones and TPO Ab among reproductive aged women by various ovarian reserve statuses, identified by age- specific AMH levels in a population based cohort study, the Tehran Thyroid Study, with an average 12 years of follow up Several studies show an inverse association between ovarian reserves, hypothyroidism and thyroid autoimmunity in humans and animals [10, 11]; to the best of our knowledge, the interaction between changes in thyroid functions and ovarian reserves status has not yet been reported and it is unclear whether or not women with poor ovarian reserves are at increased risk of occurrence of hypothyroidism.
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