| Objective To investigate the effect of different levels of thyroid stimulating hormone(TSH)on the clinical characteristics and endocrine metabolism of patients with polycystic ovary syndrome(PCOS)of phlegm dampness syndrome.In order to provide a theoretical basis for the clinical treatment of PCOS patients with hypothyroidism / subclinical hypothyroidism and further explore the relationship between PCOS and thyroid function.Methods: from August 2018 to December 2020,515 patients with PCOS were selected,including 313 patients with non phlegm dampness syndrome and 202 patients with phlegm dampness syndrome.According to the concentration of TSH,the patients who met the diagnostic criteria of PCOS and phlegm dampness syndrome were divided into three groups: group I(TSH ≤ 2.5 μ IU / ml,n = 121),group II(2.5μ IU / ml ≤ TSH ≤ 4.0 μ IU / ml,n = 50)and group III(TSH ≤ >4.0μ IU / ml,n =31).Results:(1)compared with the non phlegm dampness group,the levels of BMI,WHR,FPG,fins,120 min insulin,IR,HDL,LDL and APOB in the phlegm dampness group were significantly higher than those in the non phlegm dampness group(P ≤0.05);the levels of LH/FSH,SHBG,TG,APOA / APOB in the phlegm dampness group were significantly higher than those in the non phlegm dampness group(P ≤0.05),FT4 was significantly lower than that in non phlegm dampness group(P < 0.01);there was no significant difference in age,FSH,LH,E2,T,DHEAS,AND,120 min glucose,TC,APOA,FT3,TSH between the two groups(P > 0.05).(2)Comparison among group I,group II and group III of phlegm dampness syndrome: comparison of clinical indexes and external characteristics WHR of group I(TSH ≤ 2.5 μ IU / ml)was significantly lower than that of group II and group III(P ≤ 0.05),and there was no significant difference in other indicators among the three groups,but the body weight and BMI of group II and group III were higher than that of group I,the three groups were obese and all of them were abdominal obesity;sex hormone level comparison: AND value of group I and group II was significantly higher than that of group III(P ≤ 0.05).There was no significant difference in the levels of other sex hormones among the three groups(P ≥ 0.05);comparison of glucose metabolism indexes: FPG and FINS values of group I were significantly lower than those of group II and group III(P ≤ 0.05);30min insulin levels of group I and group II were significantly higher than those of group III(P ≤ 0.05),IR values of group I were lower than those of group II and group III(P ≤ 0.05).The IR of the three groups were all higher than 2.69.There was no significant difference in 30 min glucose level,60 min and 120 min glucose and insulin levels among the three groups(P > 0.05);the APOA /APOB value of group I and group II was significantly lower than that of group III(P≤ 0.05),and there was no significant difference in other lipid metabolism indexes among the three groups,but the TG of group II and group III was significantly lower than that of group III,LDL value was higher than that of group I,TC value was lower than that of group I;compared with group I,TSH in group II and group III was significantly higher(P ≤ 0.05),and TSH concentration in group III was significantly higher than that in group II(P ≤ 0.05).There was no significant difference in FT3 and FT4 levels among the three groups(P > 0.05).Conclusion:(1)Compared with PCOS patients with other syndromes,PCOS patients with phlegm dampness syndrome showed more disorder in sex hormone level,thyroid function and glucose and lipid metabolism.(2)PCOS patients with phlegm dampness syndrome combined with hypothyroidism / subclinical hypothyroidism had more serious disorder in hormone level,glucose and lipid metabolism,which suggested that TSH had a negative impact on PCOS patients’ upgrading and endocrine system.In order to control the further development of the disease,high attention,early prevention and timely drug intervention should be given to these patients. |
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