Background: Despite available treatment for hypothyroidism, L-thyroxine replacement therapy in a biochemically appropriate dose does not necessarily relieve patients' symptoms and complaints. The aim of the study was to evaluate the concerns of patients treated with hypothyroidism and to correlate these concerns with different patient characteristics and thyroid biochemical control. Subjects and Methods: one hundred eighteen treated primary hypothyroid patients attending Al-Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC) in Al-Basrah were entering a questionnaire designed to capture personal, anthropometric, biochemical and clinical data. Twenty-four concerns were questioned to the patients who score these concerns on a 4 point Likert scale. Results: The most scored patients' concerns were fatigue, neuropathic pain, lack of weight loss, cold intolerance, breathing problems, and swallowing problems. No statistically significant relations were existed between these concerns and thyroid stimulating hormone (TSH) control, except for a high TSH group which were highly likely to have concerns of feeling sick (OR: 0.27, 95%CI 0.54 to 2.0, p=0.001), neuropathic pain (OR: 0.4, 95%CI 0.17 to 1.6, p=0. 01), cold intolerance (OR: 0.35, 95%CI 0. 0.3 to 1.7, p=0.005), and hair problems (OR: 0.26, 95%CI 0.6 to 2.1, P<0.0001). A significant correlation existed between duration of the hypothyroidism and patients' concerns of swelling of the hands and feet (R=0.7 P<0.0001), memory problems (R=0.4 P<0.0001), hearing disturbance (R=0. 38 P<0.0001), and hair problems (R=0. 3 P=0.001). Age significantly affects patients' concerns of memory problems (R=0. 6 P<0.0001), swelling of the hands and feet (R=0.4 P<0.0001), and hearing disturbance (R=0.37 P<0.0001). Positive correlation was present between low density lipoprotein cholesterol level and patients' concerns of cold intolerance (R=0.3 P=0.001), hair problems (R=0. 28 P=0.003), feeling sick (R=0. 2 P=0. 02), and neuropathic pain (R=0.18 P=0.04). The total cholesterol level also showed a positive correlation with patients' concerns of cold intolerance (R=0.3 P=0.001), hair problems (R=0. 25 P=0.01), neuropathic pain (R=0. 22 P=0. 01), and fatigue (R=0. 2 P=0.04). Conclusion: We cannot rely on the TSH level alone as a marker of optimal treatment outcome in patients with primary hypothyroidism because it does not reflect the concern status of the patients.

BACKGROUND: Obese women with polycystic ovary syndrome (PCOS) are at high risk for developing type 2 diabetes mellitus (T2DM). A baseline oral glucose tolerance test (2-h OGTT) is important to screen for dysglycemia in PCOS particularly those high risk women. Due to its advantages by fasting is not required and less day-to-day variability, glycated hemoglobin (HbA1c) might be a convenient screening tool. This study aimed to evaluate the performance of HbA1c vs. 2-h OGTT in the diagnosis of glycemic disorders in PCOS and to evaluate the correlation between glycemic disorders, insulin resistance (IR), and anthropometric measures.METHODS: One hundred and twenty nine women diagnosed with PCOS according to the Rotterdam 2003 criteria in Basrah were included in the study. All subjects were examined for weight, body mass index (BMI) and waist circumference (WC). Then they were tested for fasting glucose, 2-h OGTT, HbA1c, and fasting insulin to assess IR.RESULTS: The result of 2-h OGTT test showed that there were 21 subjects (16.1%) showed to have IGT. The result of HbA1c test showed that 25 subjects (19.4%) were diagonised with prediabetes. Meanwhile FPG test result showed that 34 subjects (26.4%) were having IFG. The HbA1c examination showed an underdetected the diagnosis of T2DM (0.8%) and an overdeteced diagnosis of prediabetes (19.4%) (p=0.021) and at HbA1c 5.55% (37.2 mmol/mol), the specificity was (74.3%) and sensitivity (56.5%) to discriminate normal from abnormal glucose status. Ninety nine women (76.7%) were either overweight or obese and most of them had IR (76.8%).CONCLUSION: Screening of glycemic disorders is crucial for PCOS by using 2-h OGTT regardless of risk factor and HbA1c seems to be an unsatisfactory screening tool to predict glycemic disorders in women with PCOS.KEYWORDS: PCOS, glycemic disorders, OGTT, HbA1c, insulin resistance, and prediabetes

Background: Obese women with PCOS are at high risk for developing diabetes mellitus (T2DM). A baseline oral glucose tolerance test (2hrs-OGTT) annually is an important to screen for dysglycemia in women with PCOS particularly those with at least one risk factor. Due to its advantages by fasting is not required and less day-to-day variability during periods of stress or illness, glycated hemoglobin (HbA1c) might consider a convenient screening tool. This study aimed to evaluate the performance of HbA1c versus 2hrs-OGTT in the diagnosis of glycemic disorders in women with PCOS and to evaluate the correlation between glycemic disorders, insulin resistance (IR), and anthropometric measures. Patients and methods: One hundred and thirty women of a mean age 26.3 ± 6.85 year were diagnosed with PCOS according to Rotterdam 2003 criteria in Basrah, Southern Iraq. All women were examined for weight, BMI and waist circumference then they were sent for fasting plasma glucose (FPG), 2hrs-OGTT, HbA1c, and fasting insulin to assess IR. Results: By 2hrs-OGTT, impaired glucose tolerance and T2DM were diagnosed in 16.1% and 2.4% of women with PCOS respectively and 6.7% of lean women were prediabetes. HbA1c was underestimate the diagnosis of T2DM (0.8%) and overestimate prediabetes (20%) (p=0.011) and at HbA1c= 5.55%, the specificity was (74.3%) and sensitivity (56.5%) to discriminate normal from abnormal glucose status in women with PCOS (AUC: 0.645; 95% C.I.: 0.503–0.77; p = 0.03). One hundred women (76.9%) were either overweight or obese and most of them had IR (78%). Conclusion: screening of glycemic disorders is a crucial for PCOS by using 2hrs-OGTT regardless risk factor and HbA1c seems to be unsatisfactory screening tool to predict glycemic disorders in women with PCOS.

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