PCOS患者亚临床甲状腺功能减退与代谢异常的相关性研究

Study on the correlation between subclinical hypothyroidism and metabolic abnormalities in the patients with PCOS

目的探讨多囊卵巢综合征(PCOS)患者亚临床甲状腺功能减退(SCH)与内分泌代谢异常的相关性。方法回顾性分析2016年6月~2018年12月在东昌府人民医院就诊的PCOS患者65例,另选取同期就诊的身体健康、月经周期和妇科B超正常的不孕症女性115例作为对照组。按促甲状腺激素(TSH)水平,PCOS患者分为A组(TSH<2.5 mIU/L),B组(2.5 mIU/L≤TSH<4 mIU/L),C组(TSH>4.0 mIU/L),比较各组内分泌代谢特征的差异。结果 PCOS组体重指数(BMI)、游离甲状腺素(FT4)、黄体生成素(LH)、LH/卵泡刺激素(FSH)、睾酮(T)及2.5 mIU/L≤TSH<4 mIU/L发病率均高于对照组(P<0.05),TSH>4 mIU/L发病率增高(P>0.05)。PCOS组内比较:随着TSH升高,糖类代谢指标均升高(P>0.05);C组TSH、胰岛素抵抗β细胞功能指数高于A、B两组(P<0.05);B组的FSH比A组略有升高(P<0.05)。结论 PCOS患者更容易出现肥胖和代谢异常,TSH>4 mIU/L组PCOS患者代谢异常更加明显,可以作为诊断PCOS患者SCH的截点。

Objective To investigate the relationship between subclinical hypothyroidism(SCH) and endocrine and metabolic abnormalities in the patients with polycystic ovary syndrome(PCOS). Methods 65 patients with PCOS who were diagnosed in Dongchangfu District People's Hospital from June 2016 to December 2018 were retrospectively analyzed, and another 115 infertile women with normal physical heatth, menstrual cycle and gyneldogical B-mode Ultrasonography were assigned to the control group. According to thyroid stimulating hormone(TSH) level, PCOS patients were divided into group A (TSH<2.5 mIU/L), group B (2.5 mIU/L≤TSH<4 mIU/L), and group C (TSH>4.0 mIU/L). The differences in endocrine and metabolic characteristics were compared between each group. Results The body mass index (BMI), free thyroxine (FT4), luteinizing hormone (LH), LH/follicle stimulating hormone (FSH), testosterone (T) and incidence rate of 2.5 mIU/L≤TSH<4 mIU/L were higher in the PCOS group than in the control group(P<0.05). The incidence of TSH>4 mIU/L was increased(P>0.05). Compared within PCOS group, as the TSH was increased, the carbohydrate metabolism index was increased(P>0.05);the function index of TSH and insulin resistance β cells in group C was higher than that in group A and B(P<0.05);the FSH in group B was slightly higher than that in group A(P<0.05). Conclusion PCOS patients are more prone to obesity and metabolic abnormalities. The metabolic abnormalities of PCOS patients in TSH>4 mIU/L group are more obvious, which can be used as a cut-off point for the diagnosis of SCH in patients with PCOS.