Correlation Between Thyroid Hormone Sensitivity and the Risk of Polycystic Ovary Syndrome

Overview

Journal BMC Endocr Disord

Publisher Biomed Central

Specialty Endocrinology

Date 2024 May 30

PMID 38816692

Authors

Qian Wang

Ru Zhao

Chen Han

Zeyu Huang

Yan Bi

Xiaowen Zhang

Shanmei Shen

Affiliations

Soon will be listed here.

Abstract

Objective: There has been some confusion in earlier research on the connection between thyroid function and polycystic ovary syndrome (PCOS). This research is aimed to probe into the correlation between thyroid condition and the risk of PCOS from a new standpoint of thyroid hormone sensitivity.

Methods: This research comprised 415 females with PCOS from Drum Tower Hospital Affiliated with the Medical School of Nanjing University, and 137 non-PCOS individuals were selected as the normal control. Based on free thyroxine (FT4), free triiodothyronine (FT3), and thyroid-stimulating hormone (TSH), we calculated the thyroid hormone sensitivity indices, which consist of Thyroid Feedback Quantile-based Index (TFQI), Thyroid-stimulating Hormone Index (TSHI), Thyrotroph Thyroxine Resistance Index (TT4RI) and Free Triiodothyronine /Free thyroxine (FT3/FT4). The binary logistic regression model was adopted to investigate the correlation between thyroid hormone sensitivity indices with the risk of PCOS. Pearson or Spearman correlation analysis was employed to explore the association among thyroid-related measures with metabolic parameters in PCOS.

Results: Results of this research showed that females with PCOS had rising TFQI, TSHI, TT4RI, and FT3/FT4 levels compared with the control group. After adjustment for the impact of various covariates, there was no significant correlation between FT3/FT4 and the risk of PCOS; However, the odds ratio of the third and fourth vs. the first quartile of TFQI were 3.57(95% confidence interval [CI]:1.08,11.87) and 4.90(95% CI:1.38,17.38) respectively; The odds ratio of the fourth vs. the first quartile of TSHI was 5.35(95% CI:1.48,19.37); The odds ratio of the second vs. the first quartile of TT4RI was 0.27(95%CI 0.09,0.82). In addition, no significant correlation was observed between thyroid-related measures and metabolic measures in females with PCOS.

Conclusions: A reduction in the sensitivity of central thyroid hormone is closely correlated with a higher risk of PCOS. Further research is necessary to corroborate our findings and the supporting mechanisms.

References

Han C, He X, Xia X, Li Y, Shi X, Shan Z . Subclinical Hypothyroidism and Type 2 Diabetes: A Systematic Review and Meta-Analysis. PLoS One. 2015; 10(8):e0135233. PMC: 4535849. DOI: 10.1371/journal.pone.0135233. View

Setji T, Brown A . Polycystic ovary syndrome: update on diagnosis and treatment. Am J Med. 2014; 127(10):912-9. DOI: 10.1016/j.amjmed.2014.04.017. View

Chen L, Ming Xu W, Zhang D . Association of abdominal obesity, insulin resistance, and oxidative stress in adipose tissue in women with polycystic ovary syndrome. Fertil Steril. 2014; 102(4):1167-1174.e4. DOI: 10.1016/j.fertnstert.2014.06.027. View

Stepanek L, Horakova D, Stepanek L, Janout V, Janoutova J, Bouchalova K . Free triiodothyronine/free thyroxine (FT3/FT4) ratio is strongly associated with insulin resistance in euthyroid and hypothyroid adults: a cross-sectional study. Endokrynol Pol. 2020; 72(1):8-13. DOI: 10.5603/EP.a2020.0066. View

Sun Y, Teng D, Zhao L, Shi X, Li Y, Shan Z . Impaired Sensitivity to Thyroid Hormones Is Associated with Hyperuricemia, Obesity, and Cardiovascular Disease Risk in Subjects with Subclinical Hypothyroidism. Thyroid. 2022; 32(4):376-384. DOI: 10.1089/thy.2021.0500. View

Glintborg D, Rubin K, Nybo M, Abrahamsen B, Andersen M . Increased risk of thyroid disease in Danish women with polycystic ovary syndrome: a cohort study. Endocr Connect. 2019; 8(10):1405-1415. PMC: 6826171. DOI: 10.1530/EC-19-0377. View

Catalano R, Critchley H, Heikinheimo O, Baird D, Hapangama D, Sherwin J . Mifepristone induced progesterone withdrawal reveals novel regulatory pathways in human endometrium. Mol Hum Reprod. 2007; 13(9):641-54. DOI: 10.1093/molehr/gam021. View

Yang S, Lai S, Wang Z, Liu A, Wang W, Guan H . Thyroid Feedback Quantile-based Index correlates strongly to renal function in euthyroid individuals. Ann Med. 2021; 53(1):1945-1955. PMC: 8567884. DOI: 10.1080/07853890.2021.1993324. View

Yagi H, Pohlenz J, Hayashi Y, Sakurai A, Refetoff S . Resistance to thyroid hormone caused by two mutant thyroid hormone receptors beta, R243Q and R243W, with marked impairment of function that cannot be explained by altered in vitro 3,5,3'-triiodothyroinine binding affinity. J Clin Endocrinol Metab. 1997; 82(5):1608-14. DOI: 10.1210/jcem.82.5.3945. View

10.

Singla R, Gupta Y, Khemani M, Aggarwal S . Thyroid disorders and polycystic ovary syndrome: An emerging relationship. Indian J Endocrinol Metab. 2015; 19(1):25-9. PMC: 4287775. DOI: 10.4103/2230-8210.146860. View

11.

Lai S, Li J, Wang Z, Wang W, Guan H . Sensitivity to Thyroid Hormone Indices Are Closely Associated With NAFLD. Front Endocrinol (Lausanne). 2021; 12:766419. PMC: 8602917. DOI: 10.3389/fendo.2021.766419. View

12.

Raja-Khan N, Urbanek M, Rodgers R, Legro R . The role of TGF-β in polycystic ovary syndrome. Reprod Sci. 2013; 21(1):20-31. PMC: 5933191. DOI: 10.1177/1933719113485294. View

13.

Moran L, Misso M, Wild R, Norman R . Impaired glucose tolerance, type 2 diabetes and metabolic syndrome in polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2010; 16(4):347-63. DOI: 10.1093/humupd/dmq001. View

14.

Chen S, Sun X, Zhou G, Jin J, Li Z . Association between sensitivity to thyroid hormone indices and the risk of osteoarthritis: an NHANES study. Eur J Med Res. 2022; 27(1):114. PMC: 9275280. DOI: 10.1186/s40001-022-00749-1. View

15.

Nandi A, Chen Z, Patel R, Poretsky L . Polycystic ovary syndrome. Endocrinol Metab Clin North Am. 2014; 43(1):123-47. DOI: 10.1016/j.ecl.2013.10.003. View

16.

Hulchiy M, Zhang H, Cline J, Linden Hirschberg A, Sahlin L . Receptors for thyrotropin-releasing hormone, thyroid-stimulating hormone, and thyroid hormones in the macaque uterus: effects of long-term sex hormone treatment. Menopause. 2012; 19(11):1253-9. DOI: 10.1097/gme.0b013e318252e450. View

17.

Gleicher N, Barad D, Weghofer A . Functional autoantibodies, a new paradigm in autoimmunity?. Autoimmun Rev. 2007; 7(1):42-45. DOI: 10.1016/j.autrev.2007.06.001. View

18.

Benetti-Pinto C, Berini Piccolo V, Garmes H, Juliato C . Subclinical hypothyroidism in young women with polycystic ovary syndrome: an analysis of clinical, hormonal, and metabolic parameters. Fertil Steril. 2012; 99(2):588-92. DOI: 10.1016/j.fertnstert.2012.10.006. View

19.

Fauser B, Tarlatzis B, Rebar R, Legro R, Balen A, Lobo R . Consensus on women's health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril. 2011; 97(1):28-38.e25. DOI: 10.1016/j.fertnstert.2011.09.024. View

20.

Jostel A, Ryder W, Shalet S . The use of thyroid function tests in the diagnosis of hypopituitarism: definition and evaluation of the TSH Index. Clin Endocrinol (Oxf). 2009; 71(4):529-34. DOI: 10.1111/j.1365-2265.2009.03534.x. View