Association of thyroid-stimulating hormone with insulin resistance and androgen parameters in women with PCOS

Abstract

There is a relationship between thyroid function and insulin sensitivity and alterations in lipids and metabolic parameters. Little information is available regarding this relationship in women with polycystic ovary syndrome. However all those pathologies are also described as often affecting women with polycystic ovary syndrome. The association between thyroid-stimulating hormone <2.5 mIU/l and > or =2.5 mIU/l with insulin resistance and endocrine parameters in 103 women with polycystic ovary syndrome was studied. Clinical, metabolic and endocrine parameters were obtained and an oral glucose tolerance test was performed with calculation of insulin resistance indices. Women with thyroid-stimulating hormone > or =2.5 mIU/l had a significantly higher body mass index (P = 0.003), higher fasting insulin concentrations (P = 0.02) and altered insulin resistance indices (P = 0.007), higher total testosterone (P = 0.009) and free androgen indices (P = 0.001) and decreased sex hormone-binding globulin concentrations (P = 0.01) in comparison with women with thyroid-stimulating hormone <2.5 mIU/l. Generally, all of these parameters correlated significantly (P < 0.05) with thyroid-stimulating hormone only in women with thyroid-stimulating hormone > or =2.5 mIU/l. Women with polycystic ovary syndrome and with thyroid-stimulating hormone > or =2.5 mIU/l had significantly altered endocrine and metabolic changes.

MANAGEMENT OF ENDOCRINE DISEASE: The impact of subclinical hypothyroidism on anthropometric characteristics, lipid, glucose and hormonal profile of PCOS patients: a systematic review and meta-analysis

“…None of them reported significant differences (22,25,27,33). Finally, among the four studies that reported outcomes related to SHBG levels, only Dittrich reported that they were significantly reduced in the study group (33.65 ± 17.21 vs 43.55 ± 18.20 nmol/L, P = 0.01) (27,28,29,32).…”

“…Twelve studies were finally included in the present review, which enrolled 2654 PCOS patients (22,23,24,25,26,27,28,29,30,31,32,33). Among them, 577 women had PCOS and SCH and the remaining 2077 had PCOS only.…”

Subclinical Hypothyroidism Impact on the Characteristics of Patients with Polycystic Ovary Syndrome. A Meta-Analysis of Observational Studies

“…Only in 2, among 6 studies, total T levels were significantly higher in SCH-PCOS patients [4,35]. Increased T levels were also found in patients with SCH who had only PCOS morphology on ultrasonography [6]. In non-PCOS women, overt hypothyroidism status has been associated with low T levels [3], but the presence of anti-thyroid antibodies seems not to influence T concentrations [29].…”

“…Most subjects with subclinical hypothyroidism (SCH) have few symptoms of thyroid dysfunction, but it can lead to clinical, endocrine, or metabolic changes such as dyslipidemia, dysglycemia, insulin resistance, infertility, ovulatory dysfunction, obesity, and abnormal menstrual cycle [3,[6][7][8]. High levels of T, fT, LH, PRL, fasting and postprandial insulin, and glycated hemoglobin (HbA1C), increased homeostasis model assessment of insulin resistance index (HOMA-IR), and decreased levels of SHBG may be present in SCH [5,9,10].…”

Hypothyroidism in polycystic ovarian syndrome: a comparative study of clinical characteristics, metabolic and hormonal parameters in euthyroid and hypothyroid polycystic ovarian syndrome women

“…16 Dittrich R et al have reported altered insulin resistance indices with higher fasting insulin concentration in women with PCOS and with TSH ≥2.5 mIU/l. 17 This increased severity of insulin resistance as well as obesity could have adverse metabolic consequences in hypothyroid PCOS women.…”