The Change And Clinical Value Of Prolactin And Estradiol Levels In Hypothyroidism

In recent years, the incidence of infertility in hypothyroidism gradually has increased. There are too much reasons can cause infertility. As report, hyperprolactinaemia was found in 15% of infertility patients. The clinical symptom includes menopause, overflows, menstruation imbalance, infertility and Erection disability in male patients. All these symptoms reduce their quality of lives. And the diagnosis and treatment of hypothyroidism with HP are increasingly caused by clinicians, especially endocrine general practitioner's attention. Thyroid disease as one common of AITD, the mechanism of it was complicated. Many scholars in this regard at home and abroad have done a lot of work and has achieved some success. However, the more clear and systematic pathogenesis remains to be explored further in-depth study. In this observational study, patients with a new diagnosis of hypothyroidism in our endocrinology were approached for participation, as were healthy controls. We observe 68 patients'PRL and E2 levels between the new diagnosis's and after with normalization L- thyroxine treatment's. By determing the prevalence of hyperprolactinaemia in hypothyroidism, in order to discussion the systematic pathogenesis, We try to prove the high prevalence of hyperprolactinaemia in hypothyroidism, and provide the basic for the promotion in clinical prognosis and treatment.In this observational study, we randomly select 68 cases of patients from March 2009 to December 2010 in our hospital clinic or ward, who were clearly diagnosed as hypothyroidism. According to the appropriate diagnostic criteria, they are divided into overt hypothyroidism group, subclinical hypothyroidism group, normal group, after with L- thyroxine one month's treatment in overt hypothyroidism group, after with L- thyroxine three months's treatment in overt hypothyroidism group, after with L- thyroxine one month's treatment in subclinical hypothyroidism group, after with L- thyroxine three months's treatment in subclinical hypothyroidism group. We observe their PRL and E2 levels during the newly diagnosed hypothyroidism's and after with L-thyroxine treatment's. Applications spssl7.0 statistical software was used for data processing.In the course of counting and analyzing of clinical data, we found that: (1)There are 17 hyperprolcatinamia in 68 hypothyroidism patients, about 25% of the cases. Among them, there are 14 over hypothyroidism patients have HP, about 33.33% of over hypothyroidism group. Three subclinical hypothyroidism have hyperprolactinamia, about 11.54% of subclinical hypothyroidism group. The HP's PRL levels was fluctuated from 571.7 to 1291.3 mIU/L. The PRL levels in overt hypothyroidism group are significantly higher than the normal gourp (p<0.05). The PRL levels in subclinical hypothyroidism group is significantly higher than the normal gourp (p<0.05). The PRL levels in overt hypothyroidism group and in subclinical group are no significant difference (p>0.05). The E2 levels in subclinical hypothyroidism group and in the normal gourp are no significant difference (p>0.05). The E2 levels in overt hypothyroidism group and in the normal gourp are no significant difference (p>0.05). The E2 levels in overt hypothyroidism group and in subclinical group are no significant difference (p>0.05). (2)The PRL levels in newly diagnosed overt hypothyroidism patients are significant higher than the one month L- thyroxine trentment group (p<0.05). The PRL levels in newly diagnosed overt hypothyroidism patients are significant higher than the three months L- thyroxine trentment group (p<0.05). PRL levels in one month L-thyroxine of overt hypothyroidism and the three months L- thyroxine trentment group are no significant difference (p>0.05). The PRL levels in normal gourp and three months L- thyroxine trentment in overt hypothyroidism patients group are no significant difference (p>0.05). The E2 levels in newly diagnosed overt hypothyroidism patients and one month L- thyroxine trentment group are no significant difference (p>0.05). The E2 levels in newly diagnosed overt hypothyroidism patients and three months L- thyroxine trentment group are no significant difference (p>0.05). The E2 levels in one month L- thyroxine trentment group and three months L- thyroxine trentment group are no significant difference (p>0.05). (3) The PRL levels in newly diagnosed subclinical hypothyroidism and with one month L-thyroxine treatment group are no significant difference (p>0.05). The newly diagnosed subclinical hypothyroidism's PRL levels are significant higher than the three months L-thyroxine treatment group (p<0.05). The PRL levels of one month L-thyroxine treatment group in subclinical hypothyroidism and the three months's are no significant difference (p>0.05). To compare with the normal group, the PRL levels in three months's L-thyroxine treatment gourp in subclinical hypothyroidism are no significant difference (p>0.05). The E2 levels in newly diagnosed subclinical hypothyroidism and with one month L-thyroxine treatment group are no significant difference(p>0.05). The E2 levels in newly diagnosed subclinical hypothyroidism and with three months L-thyroxine treatment group are no significant difference(p>0.05). The E2 levels with one month L-thyroxine treatment group and with three months L-thyroxine treatment group are no significant difference (p>0.05). (4) The PRL and E2 levels with three months L-thyroxine treatment group and the normal group are no significant difference (p>0.05).(5)A positive correlation was founded between TSH and PRL levels(p<0.001, r=0.467). (6) There are four women have overflows when stimulated the breast in 68 female hypothyroidism, about 5.88% of the cases. After whit normalization L-thyroxine treatment,three wome overflows was disappeared. There are 20 women in them have menstruation imbalance, the prevalence was 29.4%. After L-thyroxine treatment was given, the symptom was improved in varying degree.In this study, PRL levels of subclinical and overt hypothyroid patients, combing with the views of expert and scholars from home and abroad in this area, we can come to the following conclusion:(1)A statistically significant elevation of PRL levels was found in hypothyroidism patients. (2) These symptoms of menopause, overflows, menstruation imbalance, infertility in hypothyroidism patients may be caused by PRL alteration. (3)PRL levels decreased to normal levels after thyroid function normalized with L-thyroxine treatment. And these symptoms of menopause, overflows, menstruation imbalance were reversible. The enlightenment from the study was:paying attention to the treatment of primary disease.