多囊卵巢综合征患者血清促甲状腺激素水平与自身免疫调控异常的关系

Thyroid-stimulating hormone in patients with polycystic ovary syndrome and its correlation with abnormal immune regulation

目的探讨多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者血清促甲状腺激素(thyroid-stimulating hormone,TSH)的水平及与自身免疫调控的相关性。方法分析2020年1月—2022年06月郑州大学附属郑州中心医院妇产科收治的288例PCOS患者为病例组,同期随机选取256例我科孕前保健健康女性为对照组。比较两组TSH、游离三碘甲状腺素(FT3)、游离甲状腺激素(FT4)及甲状腺过氧化物酶抗体(TPOAb)的差异;并比较病例组不同TSH水平的性激素[睾酮(T)、黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)]、细胞因子[白介素-6(IL-6)、白介素-17(IL-17)、干扰素-γ(γ-IFN)及转化生子因子-β1(TGF-β1)]的组间差异。分析TSH与性激素及细胞因子间的相关性。结果病例组TSH、TPOAb水平均显著高于对照组(t=10.37、30.56,均P<0.01);FT3、FT4水平均显著低于对照组(t=7.64、50.07,均P<0.01)。在TSH低、中、高水平三组PCOS病例的比较中,其LH、LH/FSH值、IL-6的组间差异均有统计学意义(F=488.32、247.81、10.16,均P<0.01);三组间性激素[FSH、E2、T]、细胞因子[IL-17、γ-IFN及TGF-β1]水平的差异均无统计学意义(均P>0.05);病例组PCOS患者TSH水平与LH表达及LH/FSH值均呈负相关(r=-0.471、-0.624,均P<0.01),与IL-6呈正相关(r=0.516,P<0.01),而与T、FSH、E 2、IL-17、γ-IFN及TGF-β1均无明显相关性(均P>0.01)。结论PCOS患者中TSH、TPOAb呈现高水平表达,FT3、FT4呈现低水平表达,TSH水平与LH、LH/FSH值呈负相关,与IL-6呈正相关。

Objective To investigate the thyroid-stimulating hormone(TSH)and thyroid hormone expressions in patients with polycystic ovary syndrome(PCOS)and their correlation with sex hormones and Autoimmune regulation.Methods We selected 288 cases of PCOS in case group in outpatient department of gynecology and 256 healthy women in control group in health care department in Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2020 to June 2022.Serum TSH and thyroid hormone[free triiodothyroxine(FT3),free thyroid hormone(FT4),Thyroid peroxidase antibody(TT4)]were compared between two groups.The sex hormones[testosterone(T),luteinizing hormone(LH),follicle-stimulating hormone(FSH),estradiol(E 2)],the level of IL-6,IL-17,γ-IFN and TGF-β1 were compared among PCOS patients with different TSH levels.Pearson correlation analysis was conducted to calculate the correlation between TSH and sex hormones and immune inflammatory factor.Results The PCOS group had higher level of TSH and TPOAb and lower levels of FT3,FT4 than those of the control group(t=10.37,30.56 and 7.64,50.07,respectively,all P<0.01).In the comparison of PCOS cases among three groups with low,medium and high TSH levels,the differences in LH and LH/FSH values were significant(F=488.32,247.81 and 10.16,respectively,all P<0.01),and LH and LH/FSH values in the group with high TSH level were significantly lower than those in group with low TSH level(all P<0.01).There was no statistically significant difference in the levels of IL-17,γ-IFN and TGF-β1 among three groups(P>0.01).But the difference inthe level of IL-6 among three groups was statistically significant,TSH level in PCOS case group was negatively correlated with LH expression and LH/FSH ratio(r=-0.471 and-0.624,all P<0.01)and positively correlated with the level of IL-6(r=0.516,P<0.01),but not significantly correlated with T,FSH,E 2,IL-17,γ-IFN and TGF-β1(all P>0.05).Conclusion In PCOS patients,TSH and TPOAb is highly expressed but FT3,FT4 are poorly expressed.And TSH level is negatively correlated with LH level and LH/FSH ratio,but positively correlated with IL-6.