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

Abstract

Introduction: Separately, polycystic ovary syndrome (PCOS) and subclinical hypothyroidism (SCH) exert adverse effects on several reproductive and metabolic parameters; however, in conjunction, their effects are unclear. This study evaluated the impact of SCH on reproductive and metabolic parameters in women with PCOS.

Methods: In this cross-sectional study, women with newly diagnosed PCOS were evaluated. Data on their clinical presentation and anthropometric measurements were recorded, in addition to oral glucose tolerance test, fasting lipid profile, serum thyroid-stimulating hormone (TSH), free thyroxine (FT4) and anti-thyroid peroxidase (anti-TPO).

Results: Four hundred and sixty-five women, aged 12-40 years, with PCOS were included in this study; 10.8% of them had SCH and 18.3% were positive for anti-TPO. All participants had statistically similar mean age, body mass index (BMI), waist circumference, systolic blood pressure (BP) and diastolic BP. A similar number of participants in both the euthyroid PCOS and PCOS-SCH groups had menstrual irregularity, acne, subfertility, a first-degree family member with thyroid dysfunction, acanthosis nigricans and elevated BP. Participants with SCH-PCOS had a lower modified Ferriman-Gallwey score and hirsutism frequency, though serum total testosterone levels were similar in the two groups. More subjects in the SCH group were overweight/obese, and had central obesity and goiter compared to the euthyroid group. Blood glucose, lipids and prolactin levels were similar between the two groups; the frequencies of dysglycaemia and dyslipidaemia were also similar. A higher frequency of metabolic syndrome was observed in the SCH group, though the difference was not statistically significant (p=0.098).

Conclusion: In women with PCOS, the presence of SCH does not amplify the risk of metabolic and reproductive dysfunctions.