The link between metabolic features and TSH levels in polycystic ovary syndrome is modulated by the body weight: an euglycaemic–hyperinsulinaemic clamp study

Tagliaferri, Valeria; Romualdi, Daniela; Guido, Maurizio; Mancini, Antonio; Cicco, Simona De; Florio, Christian Di; Immediata, Valentina; Segni, Chantal Di; Lanzone, Antonio

doi:10.1530/eje-16-0358

Cited by 31 publications

(26 citation statements)

References 38 publications

(37 reference statements)

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“…However, these associations lost their significance after adjustment for confounding factors. Consistently, a recent study found an association between thyroid function and metabolic parameters in obese patients with polycystic ovary syndrome (PCOS), while this association disappeared in non-obese PCOS patients ( 38 ). These results might suggest that the link between thyroid function and metabolic features is modulated by body weight.…”

Section: Discussionsupporting

confidence: 56%

Association Between Thyroid Hormones, Thyroid Antibodies, and Cardiometabolic Factors in Non-Obese Individuals With Normal Thyroid Function

Liu

Duan

et al. 2018

Front. Endocrinol.

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BackgroundHypothyroidism is an important risk factor for cardiovascular diseases, and autoimmune thyroiditis (AIT) is the leading cause of hypothyroidism. Recent studies showed that even AIT patients with euthyroidism still had an increased number of early atherosclerotic lesions. However, the precise mechanism is not yet known. This study aimed to investigate the association of thyroid function, thyroid autoimmunity, and cardiometabolic risk factors in non-obese AIT patients with euthyroidism.MethodsA total of 5,608 non-obese individuals including 1,402 AIT patient and 4,206 sex-, age-, and body mass index (BMI)-matched healthy controls were recruited.ResultsThe AIT patients had significantly lower free T3 and free T4 levels, and higher TSH, antithyroid peroxidase antibodies (TPOAb) and TgAb levels. The elevated levels of high sensitivity C reactive protein (hsCRP) and homeostasis model assessment of insulin resistance (HOMA-IR) were observed in the AIT patients than the controls [hsCRP: 0.65 (0.27–1.33) vs. 0.20 (0.03–0.74) mg/L; HOMA-IR: 2.78 ± 1.60 vs. 2.33 ± 1.49; all P < 0.05]. Thyroid function was not associated with metabolic parameters and inflammatory makers, while the TPOAb titer was positively associated with the HOMA-IR and hsCRP levels after adjustment for confounding factors (all P < 0.05). Multivariate regression analysis demonstrated that the TPOAb level was an independent influencing factor for the HOMA-IR and hsCRP levels (HOMA-IR: β = 0.058, P < 0.05; hsCRP: β = 0.108, P < 0.05).ConclusionThe TPOAb level is associated with HOMA-IR and hsCRP levels independently of thyroid function in non-obese individuals. Mild deviation of thyroid function within the normal range, chronic inflammation, and insulin resistance may be the links between AIT and atherosclerosis in the non-obese population.

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Section: Discussionsupporting

confidence: 56%

Association Between Thyroid Hormones, Thyroid Antibodies, and Cardiometabolic Factors in Non-Obese Individuals With Normal Thyroid Function

Liu

Duan

et al. 2018

Front. Endocrinol.

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“…The majority of studies used the Rotterdam criteria for PCOS diagnosis and only one study used the ESHRE/ASRM criteria. Subjects included in the meta-analysis were from five different countries including Spain ( 17 ), India ( 22 ), Italy ( 20 , 23 ), Brazil ( 21 ), and China ( 24 ), while those only included in systematic review were from America ( 25 ), India ( 26 ), China ( 27 ), Brazil ( 16 ), and Iran ( 28 ). Definition for SCH varied among studies, with TSH cut-off values ranging from 2.5 to 5 mIU/L.…”

Section: Resultsmentioning

confidence: 99%

“…Since the prevalence of SCH differs from geographic region, ethnicity or age, the results of studies were inconsistent. Only 14.3% of participants had SCH in the Italian PCOS population ( 23 ), whereas 27.0% of participants had SCH in China ( 24 ). The reported prevalence of SCH in the Indian PCOS population was nearly 22.5% ( 22 ), which was higher than that in Brazil ( 21 ).…”

Section: Discussionmentioning

confidence: 99%

Subclinical Hypothyroidism in Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

et al. 2018

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Background: The association between subclinical hypothyroidism (SCH) and polycystic ovary syndrome (PCOS) has been reported in several studies, but it is not well-recognized. The aim of this study was to evaluate the prevalence of SCH in women with PCOS.Methods: An extensive literature search was conducted in PubMed, Embase, Web of Science, and Cochrane Library databases. All articles published before May 2018 was considered for eligibility. No language restrictions were implemented. The prevalence of SCH in PCOS was calculated by the meta-analysis to produce an odds ratio (OR) with 95% confidence interval (CI).Results: A total of 6 studies including 692 PCOS patients and 540 controls were eligible for the meta-analysis. The combined odds ratio (OR) of SCH risk for women with PCOS compared with controls was 2.87 (95% CI = 1.82–9.92; P < 0.000001). The OR increased to 3.59 when limiting thyroid stimulating hormone (TSH) cut-off to ≥4 mIU/L.Conclusions: Women with PCOS are more likely to develop SCH.

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“…TSH düzeyi ile estradiol (E2) ve seks hormon bağlayıcı globulin düzeyleri arasında da negatif korelasyon bulunmuştur. 40 SH'li kadınlarda PKOS oranı da yüksek olarak saptanmıştır. İlişkili olarak SH'de menstü-rasyon düzensizlikleri sık görülmekte ve fertilite indeksi düşmektedir.…”

Section: Subkli̇ni̇k Hi̇poti̇roi̇di̇ Ve İnsüli̇n Di̇renci̇ Metaboli̇k Sendromunclassified

The Issue of Subclinical Hypothyroidism: Should it be Treated or Not?

Yürekli¹,

Kabalak²,

Altiner³

2016

Turkiye Klinikleri J Endocrin

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The link between metabolic features and TSH levels in polycystic ovary syndrome is modulated by the body weight: an euglycaemic–hyperinsulinaemic clamp study

Abstract: Our data confirm that the prevalence of SCH is increased in PCOS women. The presence of SCH is associated with endocrine and metabolic imbalances of PCOS, and the excessive body weight seems to promote this interplay.

Cited by 31 publications

References 38 publications

Association Between Thyroid Hormones, Thyroid Antibodies, and Cardiometabolic Factors in Non-Obese Individuals With Normal Thyroid Function

Association Between Thyroid Hormones, Thyroid Antibodies, and Cardiometabolic Factors in Non-Obese Individuals With Normal Thyroid Function

Subclinical Hypothyroidism in Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

The Issue of Subclinical Hypothyroidism: Should it be Treated or Not?

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