Correlation Study Of The Autoimmune Thyroid Disease And Premature Ovarian Insufficiency

Objective To explore the correlation between autoimmune thyroid disease（AITD）and premature ovarian insufficiency（POI）,and to clarify the changes of thyroid function and the impact of anti-thyroid autoantibody（ATA）positive on ovarian reserve function,so as to provide basis and new ideas for the etiological research and early clinical diagnosis of POI.Methods Select women who visited the reproductive endocrine clinic or gynecological clinic and physical examination center of Hangzhou obstetrics and gynecology hospital from January 2018 to November 2021,and have tested five indexes of thyroid function,two items of ATA,anti-Müllerian hormone（AMH）and six items of sex hormones in the same period.In addition,personal information and relevant clinical data were queried and obtained according to personal information.According to the inclusion and exclusion criteria,a total of 287 study populations were included and according to the different diagnostic criteria,they were divided into 141 cases in the case group and 146 cases in the control group.SPSS 25.0 statistical software was used for data analysis,and the general data of case group and control group were statistically described.The differences of five items of thyroid function,two items of ATA,the detection rate of abnormal thyroid function,the detection rate of ATA and the prevalence of AITD between the case group and the control group were compared.To study the effect of positive ATA on ovarian reserve function,the correlation between ATA index and ovarian reserve function index was analyzed.Finally,univariate and multivariate logistic regression analysis was carried out to explore the risk factors of causing POI and evaluate the value of predictors in the diagnosis of POI.Results 1.The study found that the incidence of thyroid dysfunction in the case group was higher than the incidence of thyroid dysfunction in the control group（37.6%vs 18.5%）.The positive rate of thyroglobulin antibody（TG-Ab）in the case group was higher than that in the control group（29.1%vs 8.9%）.The positive rate of thyroid peroxidase antibody（TPO-Ab）in the case group was higher than that in the control group（31.2%vs 1 1.6%）.The double positive rate of TG-Ab and TPO-Ab in the case group was higher than that in the control group（22.0%vs 5.5%）.The prevalence of AITD in the case group was higher than that in the control group（38.3%vs 14.4%）,and the differences between the groups were statistically significant.2.In the case group,when combined with positive ATA,the serum AMH level was 0.01（0.01,0.02）ng/ml,which was lower than that without ATA positive,and the serum FSH level was 54.81（39.38,71.31）IU/L,which was higher than that without ATA positive.The difference between these two groups was statistically significant.In the control group,when combined with positive ATA,the serum FSH level was 12.37（8.74,13.35）IU/L,which was higher than that without positive ATA,and the difference between the groups was statistically significant.3,Spearman correlation analysis found that when the serum TG-Ab level,TPO-Ab level and the incidence of AITD increased,the incidence of ovarian dysfunction and POI increased,and the positive correlation was statistically significant.Further correcting the influence of confounding factors on the results,the results were the same as before.4.After adjusting for the confounding factors,a multivariate logistic regression model was constructed and the results showed that high level of serum TG-Ab and serum TPO-Ab and AITD were risk factors,which could promote the occurrence of POI.Conclusions There is a correlation between AITD and POI these two diseases.The incidence of POI was positively correlated with the levels of serum TG-Ab,TPO-Ab and the incidence of AITD.AITD may affect ovarian reserve function through ATA.ATA with high level and AITD may be the risk factors of POI and one of the causes of POI.When ATA is positive,it is necessary to follow up the ovarian reserve function of infertile women even if the thyroid function is normal or the ovarian reserve function is normal.