| ObjectiveTo explore the clinical characteristics of autoimmune thyroid disease in polycysticovary syndrome patients, and study the correlation between the immune thyroid diseaseand insulin resistance in those patients, which plays an important role in the clinicaldiagnosis and etiology of polycystic ovary syndrome.MethodCompiled108reproductive female from Guangdong NO.2Provincial People’sHospital of Endocrinology and Reproductive Medicine clinic in May2013to November2013, there were55cases of patients with polycystic ovary syndrome (PCOS group),case-control study were53cases of “health” female (control group)， all subjects takequestionnaire, physical examination and biochemical testing; collecting anthropometricindicators such as height, weight, abdominal circumference, blood pressure, etc.; morningfasting venous blood measurements of serum free triiodo thyronine (FT3), serum freethyroxine (FT4), thyroid stimulating hormone (TSH), anti-thyroid peroxidase antibodies(TPO-AB), anti-thyroglobulin antibodies (TG-Ab), fasting blood glucose (FBG), fastinginsulin (FINS), total cholesterol (Tch), total triglyceride (TG), high density lipoproteincholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), oral glucose tolerancetest (OGTT) insulin release experiments, fasting,30min,60min,120min,180min bloodglucose and insulin levels, differences in anthropometric and biochemical indicators ofcomparison between the two groups.Result1.108subjects were included in this study; aged18to38years, mean age (26.16±4.28) years old. There are55cases in PCOS group, aged18to38years (26.38±3.68years), and53cases in the control group, aged19to37years (5.96±4.85years).There were no significant difference in age, BMI, blood pressure, heart rate, abdominalcircumference and other anthropometric indicators in the two groups. In blood lipiddetection, PCOS and control groups, respectively LDL-C (2.83±0.83) mmol/L,(1.73±0.87) mmol/L, the difference was statistically significant, Tch, TG, HDL-C difference wasnot statistically significant.2. Assessment of insulin resistance between the two groups, fasting,30min,60min,120min,180min glucose and insulin levels were higher in in PCOS group, comparedeach time point,glucose and insulin levels between the two groups were statisticallysignificance. In the PCOS group and the control group, the detection rate of insulinresistance is52.73%and15.09%, there were statistical differences between the two groups.PCOS group and the control group, the area under the curve of blood glucose control group(AUCg) were30.47and24.61, the insulin area under the curve (AUCi) were363.45and250.35, AUCg/AUCi were0.09and0.10, the differences were statistically significant.3. PCOS group and control group, TSH levels were (2.86±1.60) mIU/L,(1.91±0.46) mIU/L, TPO-Ab levels were (317.05±125.68) U/ml,(64.50±116.41) U/ml,TG-Ab levels were (120.50±94.95) U/ml,(50.70±73.58) U/ml, the difference wasstatistically significant, in PCOS group TPO-Ab positive rate was36.36%, TG-Abpositive detection rate of32.73%, in the control group, TPO-Ab positive rate was15.09%,TG-Ab positive rate was13.21%, the two groups TPO-Ab positive detection rate andTG-Ab positive detection rate difference was statistically significance. With TSH≥2.5asthe boundary between PCOS and control groups compared two groups the incidence ofsubclinical hypothyroidism, the difference was not statistically significant.4. PCOS+IR group with PCOS+non-IR group, FT4levels were (15.82±3.74)pmol/L,(17.32±5.94) pmol/L, TPO-Ab levels were (356.61±183.69) U/ml,(179.58±193.84) U/ml, TG-Ab levels were (136.42±10.94) U/ml,(95.02±13.14) U/ml, thedifference was statistically significant; non-PCOS+IR group and non-PCOS+non-IRgroup, two between groups FT3, FT4, differences TSH, TPO-Ab, TG-Ab levels was notstatistically significant; in PCOS+IR group and non-PCOS+IR group, TSH levels were (3.42±7.62) mIU/L,(2.01±0.93) mIU/L, TPO-Ab levels were (356.61±183.69) U/ml,(79.58±153.71) U/ml, TG-Ab levels were (136.42±10.94) U/ml,(45.97±62.384)U/ml, the difference was statistically significant; PCOS+non-IR group and non-PCOS+non-IR group, TSH levels were (2.63±1.65) mIU/L,(1.84±1.23) mIU/L, TPO-Ablevels were (179.58±193.84) U/ml,(56.61±133.58) U/ml.5. PCOS and control groups testo levels were (62.28±25.66) ng/dl,(48.88±27.85)ng/dl, luteinizing hormone levels were (7.83±5.03) mIU/ml,(6.31±5.67) mIU/ml,LH/FSH values were (2.73±1.59),(1.02±1.52), the difference was statisticallysignificant.6. The probability of suffering PCOS or not as the dependent variable, age, BMI,HDL-C, TG, Tch, LDL-C, HOMA-IR, FT3, FT4, TSH, TPO-Ab, TG-Ab, AITD, Testo, LH,LH/FSH, FG hirsutism score as independent variables, take logsitic regression analysis,after adjustment for confounding factors, the results showed that HOMA-IR, TPO-Ab,AITD, testo, LH, LH/FSH may have an impact on PCOS occurs, risk factors for PCOSremainder may not occur; for PCOS, AITD, IR three diseases pairwise correlation of thechi-square test, the results suggest PCOS and AITD (r=0.180, P=0.048), PCOS and IR(r=0.219, P=0.020), AITD and IR (r=0.191, P=0.045) between correlation test wasstatistically significant.ConclusionThere is a close correlation between autoimmune thyroid disease and polycystic ovarysyndrome, it is very importance for patients PCOS should check thyroid function andthyroid auto antibodies in the clinical. To the reproductive female who with autoimmunethyroid disease and insulin resistance, should be actively screening and prevention of theoccurrence of polycystic ovary syndrome. |
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