Is there a link between polycystic ovary syndrome and non-thyroidal illness syndrome?

Abstract

Objective:The aim of this study was to determine the frequency of non-thyroidal illness syndrome (NTIS) in patients with polycystic ovary syndrome (PCOS). Material and Methods:During a 6-month period, 52 patients with PCOS were recruited for this cross-sectional study. The control group included 68 age-matched female volunteers. Serum free triiodothyronine (fT3), free thyroxine (fT4), thyroid stimulating hormone (TSH), anti-thyroperoxidase antibody (anti-TPO Ab), and anti-thyroglobulin antibody (anti-Tg Ab) were measured. Results:The TSH level in the PCOS patients and controls did not differ significantly (1.9±1.2 µIU/mL vs. 1.8±0.9 µIU/mL, p>0.05). Serum fT3 and fT4 levels in the controls were significantly lower than those in the PCOS patients (fT3: 2.7±0.3 pg/mL vs. 2.9±0.3 pg/mL, p=0.02; fT4: 1.0±0.1 ng/dL vs. 1.1±0.1 ng/dL, p=0.03). The Hs-CRP (high-sensitivity C-reactive protein) level in the PCOS patients was significantly higher than in the controls (3.5±4.9 mg/L vs. 1.7±2.7 mg/L, p=0.03). A statistically significant relationship was observed between Hs-CRP and fT4 (r=0.245, p=0.015). However, NTIS was not observed in either group. Conclusion:Thyroid function abnormalities could be observed in PCOS; however, NTIS was not noted in the present study despite the inflammatory state of the PCOS patients. (J Turkish-German Gynecol Assoc 2013; 14: 216-20) Key words: Polycystic ovary syndrome, non-thyroidal illness syndrome, inflammation, hormones Received: 05 September, 2013 Accepted: 22 September, 2013 Amaç: Bu çalışmanın amacı, polikistik over sendromu (PKOS) olan hastalarda tiroid dışı hastalık sendromunun (NTIS) sıklığını tespit etmektir. Gereç ve Original Investigation 216 IntroductionPolycystic ovary syndrome (PCOS) is probably the most common endocrinopathy in women of reproductive age, and is characterised by anovulation, hyperandrogenaemia, and frequently insulin resistance (IR). It is associated with an increased risk of type 2 diabetes mellitus (T2DM) (1-3).The serum plasminogen activator inhibitor-1 (PAI-1) (4), C-reactive protein (CRP) (5, 6), advanced glycation end-products (AGEs) (7) and endothelin-1 (8) levels are all elevated in PCOS patients. These markers are known to contribute to atherogenesis and chronic inflammation (9-12).The first study to examine low-grade chronic inflammation in women with PCOS via the measurement of CRP was conducted in 2001 (13). The researchers reported that the CRP concentration was elevated in women with PCOS. PCOS patients were reported to exhibit higher mean serum tumour necrosis factor-a (TNF-a) (14), soluble intracellular adhesionmolecule-1 (sICAM-1), and sE-selectin levels (15). During many chronic illnesses, some aspects of thyroid hormone metabolism may change, which is collectively known as non-thyroidal illness syndrome (NTIS). Non-thyroidal illness is characterised by a decrease in the serum T3 level and it is thought that decreased extrathyroidal conversion of T4 to Is there a link between polycystic ovary syndrome and non-thyroidal illness sy...

Correlation between serum thyroid stimulating hormone level and glycolipid metabolism in patients with polycystic ovary syndrome

“…[15] This undesirable signaling pathway stimulation may lead to changes in TSH expression in the body, which, in turn, may become a risk factor for PCOS. [16] Many patients with thyroid dysfunction have mental health problems, which are not only related to the endocrine system itself but also to many inflammatory reactions in the body, which indirectly constitute the risk factors for PCOS. [17] Because many metabolites of inflammatory reactions in the body can act on signaling pathways related to the function of the metabolic system of the human body, the metabolic problems caused by inflammation may be a defensive response of the body to stimulation.…”

“…[ 15 ] This undesirable signaling pathway stimulation may lead to changes in TSH expression in the body, which, in turn, may become a risk factor for PCOS. [ 16 ]…”