The Study On The Correlation Between Polycystic Ovary Syndrome And Subclinical Hypothyroidism

BackgroundPolycystic ovary syndrome(PCOS)is a common and complex gynecological endocrine disease.The basic clinical features include hyperandrogenism,sustained non-ovulation and insulin resistance in puberty and menopause women,usually combined with multi system performance such as irregular menstruation,infertility,hirsutism,obesity and so on.Complicating diseases including coronary heart disease,diabetes mellitus,insulin resistance and metabolic syndrome,hypertensionin are common in long-term course of the disease,with the incidence about 10% in childbearing age women.Hypothyroidism is a systemic metabolic syndrome which is caused by various reasons of low thyroid hormone levels or low thyroid hormone resistance.The clinical manifestations are low metabolic status,apthy and myxedema,et al.The common causes include:(1)autoimmune injury;(2)thyroid destruction;(3)iodine excess;(4)antithyroid drugs.The most common type of hypothyroidism is subclinical hypothyroidism,and autoimmune hypothyroidism is the most common cause.A large number of epidemiological data show that the incidence rate of subclinical hypothyroidism in polycystic ovary syndrome is significantly higher than that in general population.ObjectiveTo explore the relationship between polycystic ovary syndrome with subclinical hypothyroidism,provide a new breakthrough point for further explore the pathogenesis of polycystic ovary syndrome,and also provide new targets for intervention or treatment of polycystic ovary syndrome.MethodsTotal 57 patients with polycystic ovary syndrome were recruited as PCOS group,who aged 18 to 30 years old,once visited doctors in the department of endocrinology or reproductive department of Second Hospital of Jilin University from May 2015 to December 2016.Other age-matched57 patients with polycystic ovary syndrome and subclinical hypothyroidism who visited doctors in the same term as PCOS with hypothyroidism group.At the same time,according to TPO-Ab positive or not,the PCOS with hypothyroidism patients were divided into TPO-Ab positive group and TPO-Ab negative group.All the participants are needed to collect medical history information,physical examination and biochemical tests.As well,following-up the PCOS with hypothyroidism patients to observe the pregnancy outcome.Using SPSS21.0 statistical software for analysis of statistics,with P < 0.05 judged as statistically significant.Results1?In general information and biochemical indicators,the fasting blood glucose(FPG),triglyceride(TG),fasting insulin hormone(FCP)and insulin resistance index(HOMA-IR),leptin(LP)of PCOS with hypothyroidism group was significantly higher than that of PCOS group(P <0.05);there were no significant difference in age,height,weight,body mass index(BMI),2h postprandial blood glucose(2h PPG),total cholesterol(TC),high density lipoprotein(HDL),low density lipoprotein(LDL)and 2h postprandial insulin hormone(2h CP)between the two groups.2?In three indexes of thyroid function and six sex hormones,the luteinizing hormone(LH),follicle stimulating hormone(FSH),testosterone(T)of the PCOS with hypothyroidism group were significantly lower than those of PCOS group(P <0.05);the pituitary prolactin(PRL),thyroid stimulating hormone(TSH)of the PCOS with hypothyroidism group is higher than that of PCOS group(P <0.05);there were no significant difference in the progesterone(P),estrogen(E),LH/FSH,free T3(FT3),free T4(FT4)levels between the two groups.3?In PCOS with hypothyroidism group,body height and weight of TPO-Ab positive group was significantly lower than that of TPO-Ab negative group(P <0.05);there were no significant difference in age,body mass index(BMI),fasting blood glucose(FPG),2h postprandial blood glucose(2h PPG),triglyceride(TG),total cholesterol(TC),high density lipoprotein(HDL)low density lipoprotein(LDL),fasting insulin hormone(FCP),2h postprandial insulin hormone(2h CP)and insulin resistance index(HOM A-IR),leptin(LP)levels between the two groups.4?In PCOS with hypothyroidism group,the thyroid stimulating hormone(TSH)of TPO-Ab positive group was significantly higher than TPO-Ab negative group(P <0.05);there were no significant difference in luteinizing hormone(LH),follicle stimulating hormone(FSH),testosterone(T),estrogen(E),progesterone(P),pituitary prolactin(PRL),LH/FSH,free T3(FT3),free T4(FT4)levels between the two groups.5?In the later period of following-up,the incidence of previous abortion or fetal arrest history in TPO-Ab positive group were significantly higher than those in TPO-Ab negative group(P <0.05);there were no significant statistical differences in the incidence of spontaneous abortion,threatened premature birth,amniotic fluid volume abnormality,pregnancy induced hypertension and gestational diabetes mellitusbetween the two groups.6?In the regression analysis between TSH and other parameters of the PCOS with hypothyroidism group,The TSH and progesterone levels have the correlation,without significant correlation with other parameters.Conclusion1? In polycystic ovary syndrome concominant subclinical hypothyroidism status,the influences on sex hormone levels,blood lipid profile,insulin resistance and obesity are more obviously.2?Thyroid peroxidase antibody has a certain impact on adverse pregnancy outcomes,therefore when screening patients with polycystic ovary syndrome companing subclinical hypothyroidism,thyroxine antibody should be tested.