The Correlation In Endocrine Metabolic Characteristics Between Thyroid Specific Antibodies And The Patients With Polycystic Ovary Syndrome

Objective: This study investigated the effects of Tpo Ab and Tg Ab on patients with PCOS by analyzing the differences of general clinical characteristics,glycolipid metabolism and reproductive endocrine indexes in patients with polycystic ovary syndrome(PCOS)with different phenotypes of thyroid-specific antibodies,aiming at providing clinical suggestion and guidance for the screening,diagnosis,treatment and prevention of long-term complications of PCOS.Methods: This study retrospectively selected patients with PCOS(164 cases),aged18-40 years,who attended the outpatient clinic of the Gynecology and Reproductive Medicine Center of the Affiliated Hospital of Yan’an University from January 2021 to December 2022 as the observation group,and women of childbearing age(82 cases),aged 18-40 years,who attended the clinic for tubal or male factors in this department during the same period as the control group.The observation group(PCOS group)was further divided into 4 subgroups according to the positive serum Tpo Ab and Tg Ab results,including(1)A group(44 cases),with positive serum Tpo Ab values but negative Tg Ab values;(2)B group(10 cases),with positive serum Tg Ab values but negative Tpo Ab values;(3)C group(26 cases),both serum Tpo Ab and Tg Ab values were positive;(4)D group(84 cases),both serum Tpo Ab and Tg Ab values were negative.Then,this study collected the medical history and general information(e.g.such as weight,height,age,waist circumference,hip circumference),thyroid function and related immune indexes(e.g.TSH,FT3,FT4,Tpo Ab,Tg Ab),glucolipid and other metabolic indexes(FBG,FINS,TC,TG,LDL-C,HDL-C,25(OH)D)and sex hormone indexes(e.g.FSH,LH,E2,T,P).The body mass index(BMI),waist-to-hip ratio(WHR)and insulin resistance index(HOMA-IR)were derived by further calculation.The general clinical characteristics,and the differences of glucose and lipid metabolism and reproductive endocrine function were compared between the observation and control groups,including the four subgroups of observation group,respectively.The Spearman correlation analysis module of the statistical software SPSS 23.0 was performed to analyze the relation between Tpo Ab and Tg Ab levels and various clinical indicators in PCOS patients,and their statistical features.Results:1.As for medical history and general information,the weight,BMI,waist circumference and waist-to-hip ratio of patients in the observation group were greater than those in the control group,which has statistical meaning(P< 0.05),while the indexes of age,height and hip circumference have no statistical value(P > 0.05).2.In terms of thyroid function and related immune indexes of the observation group,TSH,Tpo Ab and Tg Ab levels were greater than those in the control group,and these indexes of TSH,Tpo Ab and Tg Ab are statistically significant(P< 0.05),while the comparison of the FT3 and FT4 levels has no meaning(P > 0.05).3.The proportion of Tpo Ab,Tg Ab and both the Tpo Ab and Tg Ab positive cases in the observation group was greater than that in the control group,and the both the Tpo Ab and Tg Ab negative was lower than that in the control group.and the division of the four subgroups was statistically significant(P<0.05).The Tpo Ab positive rate in the observation group was 26.83%,and both the Tpo Ab and Tg Ab positive rate was 15.85%,or a little higher.4.Among the observation patients,there were 44 cases in group A,10 cases in group B,26 cases in group C,and 84 cases in group D.The waist circumference and Waist-to-hip ratio of patients in group D were significantly lower than those in group A and group C,with a statistically significant difference(P<0.05).The waist circumference and Waist-to-hip ratio of patients in the subgroup B were significantly lower than those in subgroup A,with a statistically significant difference(P<0.05).5.About the glucolipid and other metabolic indexes,the levels of FINS and TG of patients in the D subgroup were lower than those in the A subgroup,B subgroup and C subgroup,and the levels of 25-OH-D were higher than those in the A subgroup,B subgroup and C subgroup,and the HOMA-IR of patients in the D subgroup were lower than those in the A subgroup and C subgroup,and the level of HDL-C were higher than those in the A and C subgroups,the TG level of patients in the B subgroup was lower than that in the A and C subgroups,and the HDL-C levels of patients in the B subgroup were higher than those in the A subgroup,and the indexes of FINS、TG、25-OH-D、HOMA-IR and HDL-C have statistical meaning(P < 0.05);the differences of FPG,TC,and LDL-C levels between the four subgroups were not statistically significant(P >0.05).6.The levels of LH,LH/FSH and T in the D subgroup were lower than those in the A and C subgroups,the levels of LH,LH/FSH and T in the B subgroup were lower than those in the A and C subgroups,the indexes of LH、LH/FSH and T in the four subgroups were statistically significant(P<0.05),while the indexes of FSH,E2 and P levels are not(P > 0.05).7.The Spearman correlation analysis results indicated that the levels of Tpo Ab in PCOS patients were negatively correlated with HDL-C and 25-OH-D(P < 0.05),and were positively correlated with FPG,FINS,HOMA-IR,TG,LDL-C,LH and T.Tg Ab was negatively correlated with HDL-C and 25-OH-D(P < 0.05),and positively correlated with LDL-C,LH and T(P < 0.05).8.Using multiple linear regression analysis in patients with PCOS: serum Tpo Ab and Tg Ab level are respectively used as the dependent variable,and other indicators are used as independent variables,it is found that the serum Tpo Ab level in the PCOS patients have a linear regression relationship with HDL-C、25-OH-D、FPG、FINS、TG and LDL-C(P<0.05);And the serum Tg Ab level in the PCOS patients have a linear regression relationship with HDL-C、25-OH-D、T 和 LDL-C(P<0.05).Conclusion:1.The Serum Tpo Ab and Tg Ab levels of the observation group patients were higher than those of the women of normal reproductive age,presumably most PCOS patients easily accompanied by autoimmune thyroid disease.2.The thyroid specific antibodies(especially when Tpo Ab is positive or Tpo Ab and Tg Ab are both positive)may aggravate the endocrine metabolic disorders such as insulin resistance,glucose,lipids and sex hormones of the PCOS patients,which should be paid attention during clinical treatment and to provide the clinical treatment to improve the prognosis.