The Influence of Treated and Untreated Subclinical Hypothyroidism on Metabolic Profile in Women with Polycystic Ovary Syndrome

Abstract

Background. Polycystic ovary syndrome (PCOS) and hypothyroidism are the most common endocrinological disorders among women of reproductive age. Since hypothyroidism occurs more frequently in PCOS patients, it is vital to explain its clinical impact. Aim. To evaluate the impact of subclinical hypothyroidism (SCH) and its treatment on the metabolic profile of patients with PCOS. Methods. 190 women with PCOS phenotype A were enrolled in the case-control study. They were divided into three groups: 38 women with PCOS and subclinical hypothyroidism, 76 women with PCOS and SCH under thyroid replacement therapy, and 76 women with PCOS and normal thyroid function (control group). Serum lipids, fasting glucose, and insulin, as well as oral glucose tolerance tests were performed. Results. In the analyzed parameters, there were no statistic differences between the groups in relation to thyroid function. BMI turned out to be the main factor dividing the patients in terms of serum lipids, fasting glucose, fasting insulin, and oral glucose tolerance test. TSH was associated with total cholesterol and LDL cholesterol levels, whereas BMI has a dominant impact on HDL cholesterol, triglycerides, glucose, and insulin resistance. Conclusions. SCH is associated with mild lipid serum alterations in women with PCOS, but it is BMI to have a dominant impact on glucose and insulin. It seems that treatment of SCH in PCOS does not significantly alter lipid and glucose metabolism.

The influence of hypothyroidism, hyperthyroidism, autoimmune thyroiditis and thyroid cancer on the risk of polycystic ovary syndrome: a Mendelian Randomization study

“…Glintborg, D. et al found an increased risk of hypothyroidism, Graves' disease, goiter, and thyroiditis in the Danish population with PCOS [3]. Similar ndings have been found in many studies [4][5][6][7][8][9]. A recent large sample meta-analysis study [10,11] also revealed a strong association between thyroid disease and PCOS.…”

Influence of Subclinical Hypothyroidism on Women With Polycystic Ovary Syndrome: A Literature Review

“…Another study conducted in 2012 [16], which included 20 women with PCOS and SCH and 39 women with PCOS and euthyroid status, revealed significantly elevated fasting insulin levels and HOMA-IR values. A more recent cross-sectional study (2018), which included 137 females diagnosed with PCOS and having SCH, revealed impaired fasting plasma glucose (FPG) and impaired insulin sensitivity [15].…”

“…Insulin resistance is more common among women with SCH than those without SCH [ 15 ], which reveals some association between SCH and insulin resistance; however, the exact mechanism of which is not clear. A significant dependence between TSH value and insulin resistance has been described by Mueller et al [ 14 ] in women with PCOS, irrespective of their BMI [ 16 ]. The Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) is an insulin resistance index used to determine a person's chances of developing diabetes; it has been well documented by Mueller et al in 2009.…”

“…A study, which included 70 women with TSH values less than 2.5 mlU/l and 33 women with TSH values more than 2.5 mlU/l, revealed that women with PCOS and SCH had an elevated HOMA-IR value and subsequently greater risk of developing diabetes [ 17 ]. Another study conducted in 2012 [ 16 ], which included 20 women with PCOS and SCH and 39 women with PCOS and euthyroid status, revealed significantly elevated fasting insulin levels and HOMA-IR values. A more recent cross-sectional study (2018), which included 137 females diagnosed with PCOS and having SCH, revealed impaired fasting plasma glucose (FPG) and impaired insulin sensitivity [ 15 ].…”

Effect of Oral Chinese Herbal Preparations Regulating Intestinal Flora on Lipid Metabolism Disorders in Patients: A Meta-Analysis of Controlled Clinical Studies

“…With the gradual improvement of people's living standards and changes in dietary structure in China, dyslipidemia has become one of the major diseases threatening the health of middle-aged and elderly people, and is the main cause of atherosclerosis (AS) and coronary heart disease (CHD), damaging the health of patients ( 2 ). Lipid metabolism disorders often emerge with diseases such as obesity, diabetes, and ovarian syndrome, causing complex effects on the human body ( 3 ). Therefore, it is clinically important to seek treatments that effectively regulate the disorders of lipid metabolism and prevent the occurrence of dyslipidemia.…”