Correlation Between Thyroid Stimulating Hormone And Hyperandrosenemia In Patients With Non-obese Polycystic Ovary Syndrome

[Objective]:To investigate the correlation between thyroid stimulating hormone(TSH)and hyperandrogenemia(HA)in non-obese patients with polycystic ovary syndrome(PCOS)[Methods]:This study included 46 non-obese PCOS patients aged 18-40 years who were admitted to the Endocrinology and Metabolism Department of The Third Affiliated Hospital of Suzhou University from 2017 to 2019 to detect the prevalence of combined HA in different TSH levels.Multivariate regression analysis of TSH,free triiodothyronine(FT 3),free thyroxine(FT4),anti-thyroid peroxidase antibodies(TPO-Ab)and testosterone(T),estrogen(E2),luteinizing hormone(LH),follicle stimulating hormone(FSH),LH/FSH,and dehydroepiandrosterone sulfat(DHEA-S)relevance.PCOS patients were divided into subclinical hypothyroidism(SCH)and normal thyroid function groups(control group)according to the TSH of 2.5mU/L and 4.0mU/L as the diagnostic cutoff points for SCH,sex hormones,triglyceride(TG),total cholesterol(TC),low density lipoprotein(LDL),high density lipoprotein(HDL),fasting blood glucose(FBG)and fasting insulin(FINS)were compared between the two groups.The ROC curve analysis was used to predict the critical value of TSH when PCOS patients develop HA,and divided into two groups according to the cutoff value,comparison of indicators of sex hormones,glucose metabolism and lipid metabolism in two groups of PCOS patients.[Results]:1)As the TSH level of non-obese PCOS patients gradually increases,T concentration gradually increases,the incidence of HA increases.2)TSH levels in PCOS patients were positively correlated with T(r=0.399,P<0.05),and there was no significant correlation with E2,LH,FSH,LH/FSH,and DHEA-S,and FT3 was positively correlated with T(r=0.379,P<0.05),FT3 was positively correlated with LH(r=0.329,P<0.05),and had no significant correlation with E2,FSH,LH/FSH,and DHEA-S.3)According to TSH values of 2.5mU/L and 4.0mU/L as the SCH diagnostic cutoff points,T in the SCH group was significantly higher than that in the control group(P<0.05).However,FBG,FINS,TC,TG,LDL and HDL in the SCH group were not significantly different from those in the control group.4)When TSH=2.66mU/L is used as the cutoff value,the sensitivity and specificity of HA prediction are the highest,63.0%and 81.3%,respectively.5)The levels of T and LH in TSH?2.66mU/L group were significantly higher than those in TSH<2.66mU/L group,the difference was statistically significant(P<0.05),there were no significant differences in FBG,FINS,TC,TG,LDL and HDL between the two groups.[Conclusions]:1)There is a correlation between TSH levels and HA in non-obese PCOS patients.As TSH levels increase,T and LH levels change significantly,increasing the possibility of developing HA.2)When PCOS patients are combined with SCH,T level is significantly increased,and the disorder of sex hormone metabolism is more serious than that of normal thyroid function group.3)When the TSH level of non-obese PCOS patients is higher than 2.66mU/L,the patients have disordered sex hormone levels and are more susceptible to HA.Therefore,non-obese PCOS patients with TSH exceeding 2.66mU/L should be concerned in clinical practice.