Endocrine Abstracts

Subclinical hypothyroidism (SH) may affect the gonadotropic axis at different levels, causing changes in the hypothalamic–pituitary unit, functions of the gonads, and changes on peripheral metabolism of sex hormones. Polycistic ovary sndrome (PCOS) is a complex endocrine syndrome characterized by the combination of reproductive aberrations, namely hyperandrogenism and chronic anovulation, with metabolic defects.

The aim: To determine the role of SH and vitamin D deficiency (VDD) in the development of menstrual disorders in women with PCOS.

Materials and methods: The study included 100 women with PCOS (diagnosed by respecting the Rotterdam criteria). Patients to be included in the study required not to receive any medication within the last 6 months. Fasting serum glucose, basal insulin, insulin during OGTT, HOMA-IR index, TSH, FT₃, FT₄, thyroid autoantibodies (anti-Tg, anti-TPO), FSH, LH, PRL, total testosterone, DHEA-S, androstendione and free testosterone were determined.

Results: The mean age of subjects was 30.91±9.21 years and mean BMI was 29.24±3.85 kg/m². The mean TSH was 5.89±2.01 mIU/l. Approximately 61% of PCOS had SH. 26% have elevated anti-Tg and 45% had elevated anti-TPO. Patients with SH had in the same time and VDD (<20 nmol/l). PCOS were divided in two groups: PCOS with SH/VDD and PCOS without SH/VDD. Most patients were with normal values of FSH, E₂, progesterone and PRL. The level of testosterone (3.08±0.95 vs 2.03±0.64 nmol/l), androstendione (3.94±1.03 vs 2.56±0.87 ng/ml), DHEA-S and LH was higher in PCOS group with SH/VDD. HOMA-IR index was increased in 26% PCOS with SH. Disruption of menstrual cycle, usually oligomenorrhea type, was present in 36% of subjects. SH was significantly correlated with disorders of the menstrual cycle in PCOS women (r=0.76). VDD and SH were significantly correlated with PCOS, estimated based on the LH/FSH ratio (r=0.76).

Conclusion: SH and VDD significantly correlated with disorders of the menstrual cycle in PCOS women, thereby confirming their role in the occurrence of menstrual disorders in women with PCOS.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.