Endocrine Abstracts

Introduction: Polycystic ovary syndrome (PCOS) is a common disorder characterized by chronic anovulatory oligo-amenorrhea and signs of hyperandrogenism. In this study, we aimed to determine prevalence of thyroid nodules and autoimmune thyroid diseases in patients with PCOS.

Methods: Patients diagnosed with PCOS in our endocrinology clinic were included in the study. In patients with irregular menses and/or hirsutism, the diagnosis of PCOS was made by high serum LH/FSH ratio, high serum free testesteron levels and/or polycytic ovaries in pelvic ultrasonography. Serum thyrotropin, free thyroid hormones, antithyroid peroxidase (AntiTPO) and antithyroglobulin (AntiTg) antibody levels were evaluated. Thyroid ultrasonography was performed in all subjects by the same examiner. Thyroid fine needle aspiration biopsy (FNAB) was carried out when indicated.

Results: There were 107 women with PCOS with a mean age of 23.96±5.70. Seventeen (15.9%) patients had hypothyroidism and 2 (1.8%) had hyperthyroidism. 30.5% patients had positive AntiTPO, 30.5% had positive AntiTg and 37.8% had positive AntiTPO or AntiTg antibodies. Thyroid nodules were detected in 29 (27.1%) patients, 10 had solitary and 19 had multiple nodules. FNAB was performed in 11 patients with nodules; 10 were cytologically benign and 1 was malignant (papillary thyroid carcinoma was confirmed histopathologically). Totally, in 54 (50.5%) patients, there was a thyroid related disease such as positive thyroid antibodies, thyroid dysfunctions or nodules. Insulin resistance calculated with HOMA-IR was ≥2 in 47 (43.9%) and <2 in 60 (56.1%) patients. Nodule prevalence, thyroid dysfunctions, thyroid autoantibody positivity and thyroid volume did not differ between PCOS patients with and without insulin resistance.

Conclusion: Thyroid pathologies are observed in half of the patients with PCOS. Measurement of thyroid hormones are usually a part of investigation in PCOS patients, but we think serum thyroid autoantibodies and presence of thyroid nodules should also be searched in these patients.