亚临床甲状腺功能减退症对多囊卵巢综合征患者内分泌代谢特征的影响

Effect of subclinical hypothyroidism on endocrine and metabolic characteristics of patients with polycystic ovary syndrome

目的分析亚临床甲状腺功能减退症(SCH)对多囊卵巢综合征(PCOS)患者内分泌代谢特征的影响,并探讨促甲状腺激素(TSH)水平与各项内分泌代谢指标的相关性。方法选取2020年1月至2021年6月云南省第一人民医院内分泌代谢科门诊就诊的661例PCOS患者为研究对象,收集患者的一般资料及相关内分泌代谢指标。以TSH值4.2 mIU/L为SCH诊断截点,将PCOS患者分为SCH组和非SCH组;比较两组间内分泌代谢特征的差异;并对TSH水平与其内分泌代谢指标的相关性进行分析。结果PCOS患者发生SCH的比例高达31.16%。伴SCH组较不伴SCH组的PCOS患者TSH、催乳素、三酰甘油显著升高,游离甲状腺素、雌二醇显著降低(P<0.05)。TSH水平与PCOS患者游离甲状腺素呈负相关(r=-0.152,P<0.001),与总胆固醇、三酰甘油呈正相关(r=0.133、0.111,P值分别为<0.01、<0.05)。结论伴SCH的PCOS患者合并其内分泌激素紊乱、血脂异常更为严重,可能会进一步加重PCOS患者心血管系统疾病的发生风险和生殖异常。建议对PCOS患者定期进行甲状腺功能和脂质代谢的筛查,并长期随访。

Objective To analyze the effect ofsubclinical hypothyroidism(SCH)on endocrine and metabolic characteristics of polycystic ovary syndrome(PCOS)patients,and to explore the correlation between thyroid stimulating hormone(TSH)level and various endocrine and metabolic indexes.Methods Totally 661 patients with PCOS in the outpatient Department of Endocrinology and Metabolism of the First People s Hospital of Yunnan Province from January 2020 to June 2021 were selected as the research object.The general data and related endocrine and metabolic indexes of the patients were collected.Taking the TSH value of 4.2 mIU/L as the cut-off point for the diagnosis of SCH,PCOS patients were divided into SCH group and non SCH group.The differences of endocrine and metabolic characteristics between the two groups were compared;The correlation between TSH level and its endocrine and metabolic indexes was analyzed.Results The incidence of SCH in PCOS patients was 31.16%.Compared with PCOS patients without SCH,the levels of TSH,prolactin and triglyceride in the group with SCH were significantly higher,and the levels of free thyroxin and estradiol were significantly lower(P<0.05).TSH level was negatively correlated with free thyroxin in PCOS patients(r=-0.152,P<0.001),and positively correlated with total cholesterol and triglycerides(r=0.133,0.111,P<0.01,P<0.05,respectively).Conclusions PCOS patients with SCH have more serious endocrine hormone disorders and dyslipidemia,which may further aggravate the risk of cardiovascular diseases and reproductive abnormalities in PCOS patients.It is suggested that patients with PCOS should be screened for thyroid function and lipid metabolism regularly and followed up for a long time.