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

Abstract

Background/Aims: Definitive polycystic ovary syndrome (PCOS) diagnosis should exclude thyroid dysfunctions. The purpose of the study is to examine the impact of subclinical hypothyroidism on the characteristics of PCOS patients. Methods: A meta-analysis of the published observational studies was conducted. Medline, Scopus, and Cochrane database search was performed to identify the studies that compared euthyroid PCOS and subclinical hypothyroidism (SCH)-PCOS patients. A total of 9 studies were selected, totalizing the inclusion of 1,537 euthyroid PCOS and 301 SCH-PCOS. The data were expressed as raw mean difference and standard error, using the random-effects model. Heterogeneity among studies was examined using the Cochran's test (Q) and I 2 statistics. Results: Anthropometrical parameters were similar in both groups. Total cholesterol (TC) and triglyceride (TG) were higher in SCH-PCOS (p = 0.036 and p = 0.012). High-density lipoprotein cholesterol was lower in the SCH-PCOS group (p = 0.018). Fasting glucose was lower in euthyroid PCOS (p = 0.022). All androgen levels were similar in both group (p > 0.05 for all). Conclusion: TC, TG and fasting glucose were higher in SCH-PCOS patients. Because of the heterogeneity among studies, some summarized results should be interpreted with caution. Consistent data for future studies addressing PCOS diagnosis are provided.

Correlation of Subclinical Hypothyroidism With Polycystic Ovary Syndrome (PCOS)

“…We found no correlation of TSH with FBS as in contrast to the Bedaiwy et al study which showed an association between TSH and FBS [9]. De Medeiros et al showed normal FBS levels in the SCH group [22].…”

Impact of Subclinical Hypothyroidism on Reproductive and Metabolic Parameters in Polycystic Ovary Syndrome – A Cross-sectional Study from Bangladesh

“…Benetti-Pinto et al, and a meta-analysis also had similar observations. 13,14,16 Free testosterone was higher in euthyroid subjects with PCOS compared with SCH-PCOS in the study by Enzeveai et al 28 Both is assumed that presence of SCH in PCOS may be associated with higher metabolic risks. 1,5,10 In this study, we found that the euthyroid PCOS and SCH-PCOS groups had similar frequencies of acanthosis nigricans.…”

“…Previous studies have provided inconclusive results as to whether the presence of SCH in patients with PCOS has a higher CV risk than in patients with PCOS without SCH. [13][14][15][16] Data regarding the effect of SCH on clinical, hormonal and metabolic parameters in PCOS are insufficient, particularly within the context of Bangladesh. This study was conducted to explore whether the presence of SCH imparts higher reproductive and metabolic derangements in women with PCOS.…”

Subclinical Hypothyroidism in Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

“…In the long term, PCOS women with SCH might have increased risk of developing a variety of diseases. Total cholesterol (TC), triglyceride (TG) and fasting glucose were higher in PCOS with SCH ( 35 , 36 ), thus they are more likely to exhibit hyperlipidemia, impaired glucose metabolism, and cardiovascular diseases ( 24 , 37 ). SCH may also contribute to the psychological co-morbidities in women with PCOS, such as anxiety and depression, since the strong association between SCH, PCOS and depressive symptoms has been reported, respectively ( 38 , 39 ).…”