April - June 2008, Volume 4, Issue 2

Gudovan E, Diaconescu C, Oros S, Neamtu C

Autoimmune thyroiditis associated with polycystic ovary syndrome: comments about 25 cases

Acta Endo (Buc) 2008, 4 (2): 173-180
doi: 10.4183/aeb.2008.173

The aim of our prospective study is to determine the prevalence of autoimmune thyroiditis (AIT), sub clinical hypothyroidism and metabolic syndrome in patients with polycystic ovary syndrome (PCOS). Twenty-five patients with PCOS (according to Rotterdam ESHRE/ASRM criteria) aged between 20-35 years, hospitalised in the Institute of Endocrinology between January 2004 and December 2006 were selected to evaluate thyroid morphology, function and immunologic status, and were compared with a control group of 20 women without PCOS. All subjects were clinically examined (BMI, blood pressure, hirsutism) and evaluated for LH/FSH ratio, E2, P, PRL, free testosterone, TSH, TPOA, HOMA-IR, fasting glycaemia, lipid metabolism. Thyroid ultrasonography was performed with a multiple&#8211;frequency linear transducer in grey scale and colour Doppler mode. Ultrasound transvaginal examination of the ovary was also performed. Patients with PCOS had LH/FSH ratio > 2, free testosterone > 0.95 ? 0.2 mMol/L, 15 patients had TSH > 4.5 mUI/L (60 %. p < 0.001) and 7 (28 %) had high levels of TPOA. In the control group TSH and TPOA were normal. Thyroid ultrasound showed total thyroid volume of 16.54?1.80 cm3 in 60 % of patients with PCOS and 10.51 ? 1.20 cm3 in the control group. Hypoechogenic areas were present in 60 % of patients with PCOS and absent in the control group. 15 (60 %) of the patients with PCOS had insulin resistance (HOMA&#8211;IR > 3.3?1.2 mU x mMol/L), and 16 (16 %, p<0.001) had hyperlipoproteinemia. In the control group one case has hypercholesterolemia. In conclusion, this demonstrates that autoimmune thyroiditis is frequent in patients with PCOS and indicates a potential cardiovascular risk due to the association of sub clinical hypothyroidism, dislipidemia and insulin resistance and suggests that patients with PCOS should be screened for thyroid function and morphology.

Keywords: polycystic ovary syndrome, autoimmune thyroiditis, hypothyroidism, hyperandrogenism, insulin resistance

Correspondence: Emilia Gudovan, &#8220;C. I.Parhon&#8221; Institute of Endocrinology, 34-36 Bd. Aviatorilor, 011863, Bucharest, Romania, Phone/Fax: +4021.3172041-272, Email: gudovan@kappa.ro