Subclinical hypothyroidism in young women with polycystic ovary syndrome: an analysis of clinical, hormonal, and metabolic parameters

Benetti‐Pinto, Cristina Laguna; Piccolo, Vanessa Ribeiro Santana Berini; Garmes, Heraldo Mendes; Juliato, Cássia Raquel Teatin

doi:10.1016/j.fertnstert.2012.10.006

Cited by 84 publications

(89 citation statements)

References 52 publications

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“…Only the levels of triglycerides were higher in the first group (110). In 19 young PCOS women with TSH levels between 4.5 and 10 mIU/l, only LDL cholesterol levels were significantly higher when compared with 149 PCOS women with TSH levels below 4.5 mIU/l (21). Discrepancies between these two studies in young PCOS women are probably related to the small number of cases and to the uneven number of cases vs controls in both studies.…”

Section: Metabolic Risksmentioning

confidence: 76%

“…Recently, the higher prevalence of HT in women with PCOS than in controls was confirmed in 113 Italian patients with the mean age of 24 years and in 100 controls (27 vs 8%) (20). Out of 168 young Brazilian PCOS women with the mean age of 24 years, 149 (88.7%) had normal thyroid function and 19 (11.3%) subclinical hypothyroidism with TSH levels between 4.5 and 10 mIU/l, representing a higher prevalence of subclinical hypothyroidism in PCOS than in the general population (21). Referring to the Colorado thyroid disease prevalence study, the prevalence of increased TSH levels in 24-year-old women should be revealed a higher prevalence of TPO-positive autoimmune thyroiditis than in 80 controls (22.5 vs 1.25%).…”

Section: Joint Prevalencementioning

confidence: 84%

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MECHANISMS IN ENDOCRINOLOGY: Thyroid and polycystic ovary syndrome

Gaberšček

Zaletel

Schwetz

et al. 2015

European Journal of Endocrinology

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Thyroid disorders, especially Hashimoto's thyroiditis (HT), and polycystic ovary syndrome (PCOS) are closely associated, based on a number of studies showing a significantly higher prevalence of HT in women with PCOS than in controls. However, the mechanisms of this association are not as clear. Certainly, genetic susceptibility contributes an important part to the development of HT and PCOS. However, a common genetic background has not yet been established. Polymorphisms of the PCOS-related gene for fibrillin 3 (FBN3) could be involved in the pathogenesis of HT and PCOS. Fibrillins influence the activity of transforming growth factor beta (TGFb). Multifunctional TGFb is also a key regulator of immune tolerance by stimulating regulatory T cells (Tregs), which are known to inhibit excessive immune response. With lower TGFb and Treg levels, the autoimmune processes, well known in HT and assumed in PCOS, might develop. In fact, lower levels of TGFb1 were found in HT as well as in PCOS women carrying allele 8 of D19S884 in the FBN3 gene. Additionally, vitamin D deficiency was shown to decrease Tregs. Finally, high estrogen-to-progesterone ratio owing to anovulatory cycles in PCOS women could enhance the immune response. Harmful metabolic and reproductive effects were shown to be more pronounced in women with HT and PCOS when compared with women with HT alone or with controls. In conclusion, HT and PCOS are associated not only with respect to their prevalence, but also with regard to etiology and clinical consequences. However, a possible crosstalk of this association is yet to be elucidated.

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Section: Metabolic Risksmentioning

confidence: 76%

Section: Joint Prevalencementioning

confidence: 84%

MECHANISMS IN ENDOCRINOLOGY: Thyroid and polycystic ovary syndrome

Gaberšček

Zaletel

Schwetz

et al. 2015

European Journal of Endocrinology

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“…Attempts were made to contact the authors for further information but no answer was obtained. Finally, 9 full papers providing sufficient data for analysis were selected [4,8,11,12,22,26,27,34,35]. All inclusions were based on a clear description of PCOS with euthyroidism and PCOS with SCH.…”

Section: Methodsmentioning

confidence: 99%

Subclinical Hypothyroidism Impact on the Characteristics of Patients with Polycystic Ovary Syndrome. A Meta-Analysis of Observational Studies

Medeiros

Ormond

et al. 2017

Gynecol Obstet Invest

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Background/Aims: Definitive polycystic ovary syndrome (PCOS) diagnosis should exclude thyroid dysfunctions. The purpose of the study is to examine the impact of subclinical hypothyroidism on the characteristics of PCOS patients. Methods: A meta-analysis of the published observational studies was conducted. Medline, Scopus, and Cochrane database search was performed to identify the studies that compared euthyroid PCOS and subclinical hypothyroidism (SCH)-PCOS patients. A total of 9 studies were selected, totalizing the inclusion of 1,537 euthyroid PCOS and 301 SCH-PCOS. The data were expressed as raw mean difference and standard error, using the random-effects model. Heterogeneity among studies was examined using the Cochran's test (Q) and I 2 statistics. Results: Anthropometrical parameters were similar in both groups. Total cholesterol (TC) and triglyceride (TG) were higher in SCH-PCOS (p = 0.036 and p = 0.012). High-density lipoprotein cholesterol was lower in the SCH-PCOS group (p = 0.018). Fasting glucose was lower in euthyroid PCOS (p = 0.022). All androgen levels were similar in both group (p > 0.05 for all). Conclusion: TC, TG and fasting glucose were higher in SCH-PCOS patients. Because of the heterogeneity among studies, some summarized results should be interpreted with caution. Consistent data for future studies addressing PCOS diagnosis are provided.

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“…Twelve studies were finally included in the present review, which enrolled 2654 PCOS patients (22,23,24,25,26,27,28,29,30,31,32,33). Among them, 577 women had PCOS and SCH and the remaining 2077 had PCOS only.…”

Section: Included Studiesmentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: The impact of subclinical hypothyroidism on anthropometric characteristics, lipid, glucose and hormonal profile of PCOS patients: a systematic review and meta-analysis

Pergialiotis

Konstantopoulos

Prodromidou

et al. 2017

European Journal of Endocrinology

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Objective: Subclinical hypothyroidism (SCH) is encountered in 10-25% of women with PCOS. To date, it remains unclear whether this coexistence influences the severity of metabolic and hormonal profile of these patients. The purpose of our systematic review is to investigate this potential relation. Methods: We systematically searched Medline, Scopus, ClinicalTrials.gov, Cochrane Central Register of Controlled Trials (CENTRAL) and Google Scholar databases together with reference lists from included studies. All prospective and retrospective observational cohort studies that investigated the impact of subclinical hypothyroidism on hormonal and metabolic parameters of PCOS patients were included. The methodological quality of studies was assessed with the Ottawa-Newcastle criteria. Statistical meta-analysis was performed with the RevMan 5.3 software. Results: Twelve studies were finally included in the present review, which enrolled 2341 PCOS patients. Among them, 577 had subclinical hypothyroidism, whereas the remaining 2077 were PCOS women with normal thyroid function. The presence of SCH significantly affected HDL (MD -3.92 mg/dL 95% CI: -6.56, -1.29) and triglycerides levels (26.91 mg/dL 95% CI: -3.79, 50.02). HOMA-IR was also affected (MD 0.82 95% CI: 0.15, 1.50). On the other hand, LDL, fasting glucose and 2-h OGTT were not influenced. Similarly, prolactin, FSH, LH, LH/FSH ratio and sex hormone-binding globulin remained unaffected. Conclusion: Subclinical hypothyroidism does not influence the hormonal profile of women with PCOS. On the other hand, it results in mild metabolic abnormalities, which are not clinically important in a short-term setting.

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Subclinical hypothyroidism in young women with polycystic ovary syndrome: an analysis of clinical, hormonal, and metabolic parameters

Cited by 84 publications

References 52 publications

MECHANISMS IN ENDOCRINOLOGY: Thyroid and polycystic ovary syndrome

MECHANISMS IN ENDOCRINOLOGY: Thyroid and polycystic ovary syndrome

Subclinical Hypothyroidism Impact on the Characteristics of Patients with Polycystic Ovary Syndrome. A Meta-Analysis of Observational Studies

MANAGEMENT OF ENDOCRINE DISEASE: The impact of subclinical hypothyroidism on anthropometric characteristics, lipid, glucose and hormonal profile of PCOS patients: a systematic review and meta-analysis

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