Does insulin resistance increase thyroid volume in patients with polycystic ovary syndrome?

Sahin, Murat; Demircioglu, Didem; Oguz, Ayten; Tuzun, Dilek; Sarica, Mehmet Akif; Inanc, Elif; Gul, Kamile

doi:10.1590/2359-3997000000225

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Original Article • Arch. Endocrinol. Metab. 61 (2) • Mar-Apr 2017 • https://doi.org/10.1590/2359-3997000000225 linkcopy

Does insulin resistance increase thyroid volume in patients with polycystic ovary syndrome?

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective To investigate the effect of gonadotropin, sex hormone levels and insulin resistance (IR) on thyroid functions and thyroid volume (TV) in polycystic ovary syndrome (PCOS).

Subjects and methods 69 new diagnosed PCOS patients (age 24.82 ± 6.17) and 56 healthy control female (age 26.69 ± 5.25) were involved to the study. Fasting plasma glucose, lipid profile, insulin, thyroid stimulating hormone (TSH), free thyroxine (fT4), estradiol (E2), luteinizing hormone (LH), follicle stimulating hormone levels and urine iodine were measured in all participants. Thyroid and pelvic ultrasound were performed in all participants.

Results Insulin, HOMA-IR, LH, E2 and TV were higher in PCOS group (p < 0.05). TV was significantly higher in PCOS patients with IR compared to non-IR PCOS patients (p < 0.001), while TSH, fT4, and urine iodine levels were similar between these groups (p > 0.05). There was a negative correlation between E2 and TSH (p < 0.05) and a positive correlation between TSH and TV (p < 0.05). There was a significant positive correlation between TV and LH, insulin, HOMA-IR (p < 0.05).

Conclusion This study showed that TV was increased in patients with insulin resistance but differences in TSH and LH levels may affect TV changes as well.

Polycystic ovarian syndrome; thyroid volume; insulin resistance; luteinizing hormone

Parameters	PCOS group n = 69	Control group n = 56	p
Age (year)	24.82 ± 6.17	26.69 ± 5.25	0.075
BMI (kg/m²)	21.86 ± 2.08	21.48 ± 2.16	0.325
Sistolic blood pressure (mmHg)	106.59 ± 10.42	107.69 ± 11.66	0.578
Diastolic blood pressure (mmHg)	66.95 ± 7.96	67.41± 7.97	0.752
Complaint (n/%)
Hirsutism	51/73.9
Oligo/amenore	14/20.3	-	-
Acne	2/2.9
Alopecia	2/2.9
FGS	11.01 ± 2.74	2.92 ± 2.12	0.000
Ultrasonography
PCO image (n/%)	48/69.56	-	-
Mean ovary volume (mL)	10.95 ± 5.45	6.87 ± 1.27	0.000

Parameters	PCOS group n = 69	Control group n = 56	p
Glucose (mg/dL)	80.76 ± 8.62	80.62 ± 8,59	0.927
Glucose₂ (OGTT)	86.49 ± 17.70	87.69 ± 20,27	0.724
LDL (mg/dL)	89.78 ± 25.27	92.15 ± 20,28	0.09
HDL (mg/dL)	53.32 ± 10.13	56.03 ± 10,56	0.146
TG (mg/dL)	81.98 ± 43.32	90.51 ± 41,75	0.268
Insulin (uIU/mL)	11.29 ± 6.93	6.28 ± 3,44	0.000
HOMA-IR	2.29 ± 1.52	1.24 ± 0,69	0.000
LH (mIU/mL)	12.92 ± 9.16	5.50 ± 2,92	0.000
FSH (mIU/mL)	5.80 ± 3.15	6.62 ± 2,04	0.096
E2 (pg/mL)	79.07 ± 60.34	59.58 ± 38,13	0.038
Progesterone (nmol/L)	1.50 ± 1.71	1.00 ± 1,05	0.059
DHEAS (ug/dL)	265.30 ± 118.25	197.81 ± 93,95	0.001
TT (ng/dL)	50.01 ± 25.28	33.60 ± 13,34	0.000
Prolactin (ng/mL)	16.64 ± 9.69	12.94 ± 5,28	0.012
Cortisol (mcg/dL)	14.16 ± 5.63	14.68 ± 5,69	0.611
Cortisol (1 mg DST)	0.65 ± 0.28	0.77 ± 0,35	0.058

Parameters	PCOS group n = 69	Control group n = 56	p
TSH (uIU/mL)	2.49 ± 1.00	2.29 ± 1.03	0.296
fT4 (ng/dL)	1.11 ± 0.12	1.14 ± 0.13	0.09
Anti-TPO positivity (n/%)	6/ 8.7	7/12.5	0.343
Anti-TG positivity (n/%)	7/10.1	4/7.14	0.397
Thyroglobulin (ng/mL)	13.45 ± 9.58	10.94 ± 7.87	0.118
Urinary iodine (µg/L)	97.84 ± 38.30	91.83 ± 37.42	0.381
Thyroid nodule (n/%)
NG	7/10.1	6/10.71	0.446
MNG	8/11.6	3/5.35	0.371
Thyroid volume (mL)	12.68 ± 3.07	11.45 ± 3.27	0.033

	IR-PCOS n = 25	NIR-PCOS n = 44	p
TSH (uIU/mL)	2.69 ± 1.07	2.37 ± 0.96	0.213
fT4 (ng/dL)	1.10 ± 0.13	1.11 ± 0.12	0.631
Thyroglobulin (ng/mL)	11.37 ± 8.92	14.63 ± 9.84	0.177
Urinary iodine (µg/L)	94.96 ± 41.07	99.47 ± 37.03	0.641
Thyroid volume (mL)	14.43 ± 2.91	11.68 ± 2.72	0.000

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[TFN1] PCOS: polycystic ovary syndrome; BMI: body mass index; FGS: Ferriman-Gallwey score; PCO: polycystic ovary.