Thyroid disorders in polycystic ovarian syndrome subjects: A tertiary hospital based cross-sectional study from Eastern India

Abstract

Context:Polycystic ovarian syndrome (PCOS), the most common endocrinopathy of women in the reproductive age group seems to be adversely affected by associated thyroid dysfunction. Both pose independent risks of ovarian failure and pregnancy related complications.Aims:The present study from Eastern India is, therefore, aimed to investigate the prevalence and etiology of different thyroid disorders in PCOS subjects.Settings and Design:Cross-sectional hospital based survey-single centre observational case-control study.Materials and Methods:This prospective single-center study recruited 106 female patients with hypertrichosis and menstrual abnormality among which 80 patients were defined as having PCOS according to the revised 2003 Rotterdam criteria and comprised the study population. Another 80 age-matched female subjects were studied as the control population. Thyroid function and morphology were evaluated by measurement of serum thyroid stimulating hormone (TSH), free thyroxine levels (free T3 and free T4), anti-thyroperoxidase antibody (anti-TPO Ab), clinical examination and ultrasound (USG) of thyroid gland.Statistical Analysis Used:It was done by Student's t-test and Chi-square test using appropriate software (SPSS version 19).Results:This case-control study revealed statistically significant higher prevalence of autoimmune thyroiditis, detected in 18 patients (22.5% vs. 1.25% of control) as evidenced by raised anti-TPO antibody levels (means 28.037 ± 9.138 and 25.72 ± 8.27 respectively; P = 0.035). PCOS patients were found to have higher mean TSH level than that of the control group (4.547 ± 2.66 and 2.67 ± 3.11 respectively; P value < 0.05). There was high prevalence of goiter among PCOS patients (27.5% vs. 7.5% of control, P value > 0.001). On thyroid USG a significantly higher percentage of PCOS patients (12.5%; controls 2.5%) had hypoechoic USG pattern also compatible with the diagnosis of autoimmune thyroiditis.Conclusions:High prevalence of thyroid disorders in PCOS patients thus points towards the importance of early correction of hypothyroidism in the management of infertility associated with PCOS.

The relationship between lifestyle and the frequency of polycystic ovary syndrome in Saudi female residing in Riyadh

“…Thyroid diseases and PCOS are two of the most common endocrine disorders in the general population. 8 Present results revealed a significant relationship between hypothyroidism and PCOS. Previous studies showed that there is a relationship between these two entities even though they have a complete different etiopathogenesis, yet both diseases share common clinical features.…”

MECHANISMS IN ENDOCRINOLOGY: Thyroid and polycystic ovary syndrome

“…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%). PCOS patients had higher mean TSH levels, a higher prevalence of goiter (27.5 vs 7.5%), and more frequently a hypoechoic thyroid ultrasound pattern (12.5 vs 2.5%) than controls (22). Recently, a case-control Iranian study has demonstrated that, in PCOS patients, the mean level of TPO antibodies and the prevalence of clinically proven goiter were higher than those in controls without PCOS (23).…”

“…Considering the study by Janssen et al (19), two patients with PCOS, but none of the controls, had been thyroidectomized because of Graves' disease. Additionally, two Indian patients with PCOS and no controls had Graves' disease (22).…”

Does insulin resistance increase thyroid volume in patients with polycystic ovary syndrome?

“…It has been shown that autoimmune thyroid diseases are more frequent in PCOS patients (39,40), but no difference in thyroid autoimmunity between PCOS patients and healthy controls was shown as well (41). Hyperestrogenism is thought to be responsible for more frequent autoimmune diseases in women compared to men (42).…”