二甲双胍治疗多囊卵巢综合征对甲状腺功能的影响

Thyroidal effect of metformin treatment in patients with polycystic ovary syndrome

目的 观察二甲双胍治疗多囊卵巢综合征（PCOS）患者对其甲状腺功能的影响.方法 选取PCOS患者148例,分为亚临床甲状腺功能减退症组9例、甲状腺功能减退症组38例及甲状腺功能正常组101例,应用二甲双胍治疗6个月,比较治疗前后甲状腺功能的改变.结果 治疗6个月后,亚临床甲状腺功能减退症组及甲状腺功能减退症组PCOS患者促甲状腺激素（TSH）水平较治疗前明显降低[（2.77±1.47） μIU/ml vs（6.77±2.46） μIU/ml;（2.90±1.08）μIU/ml vs （4.05±0.94） μIU/ml,P＜0.05],游离甲状腺素（FT4）水平无明显改变（P＞0.05）.结论 二甲双胍治疗PCOS合并亚临床甲减及甲减患者,不影响甲状腺激素水平,且可降低TSH水平.

Objective To evaluate the effect of metformin treatment on the thyroid hormone profile in patients with polycystic ovary syndrome （PCOS）.Methods A total of 148 patients with PCOS was specifically selected for either being diagnosed of hypothyroidism or subclinically hypothyroid or euthyroid without levothyroxine treatment before the starting of metformin.The serum levels of thyroid stimulating hormone （TSH） and free thyroxine （FT4） were measured before and after a 6-month period of metformin therapy.Results Thyroid function parameters did not change after starting metformin therapy in euthyroid patients with PCOS.In the 9 hypothyroid patients and 38 subclinical hypothyroid patients with PCOS,the basal median serum levels of TSH （P 〈 0.05） decreased after a 6-month course of mefformin treatment [（2.77 ±1.47） μIU/ml vs （6.77 ± 2.46） μIU/ml;（2.90 ± 1.08） μIU/ml vs （4.05 ± 0.94） μIU/ml,P 〈 0.05].No significant change in the serum levels of FT4 was observed in these patients （P 〉 0.05）.Conclusions Mefformin treatment has no effect on thyroid hormone,but has a TSH-lowering effect in hypothyroid and subclinically hypothyroid patients with PCOS.