High prevalence of autoimmune thyroiditis in patients with polycystic ovary syndrome.
OBJECTIVE
To investigate the prevalence of autoimmune thyroiditis (AIT) in patients with polycystic ovary syndrome (PCOS).


METHODS
Over a period of 30 months, 175 patients with PCOS were recruited to a prospective multicenter study to evaluate thyroid function and morphology; 168 age-matched women without PCOS were studied as a control group.


METHODS
PCOS was defined as a- or oligomenorrhea, hyperandrogenism and exclusion of other disturbances of estrogen or androgen synthesis. All laboratory parameters were determined with automated immunoassays. Thyroid morphology was assessed by ultrasound.


RESULTS
PCOS patients were characterized by an increased LH/FSH ratio, low progesterone, elevated testosterone and a high prevalence of hirsutism (PCOS 83%, control 3%; mean hirsutism score 12+/-5 and 3+/-2 respectively), but no differences in estrogen levels were found. Thyroid function and thyroid-specific antibody tests revealed elevated thyroperoxidase (TPO) or thyroglobulin (TG) antibodies in 14 of 168 controls (8.3%), and in 47 of 175 patients with PCOS (26.9%; P<0.001). On thyroid ultrasound, 42.3% of PCOS patients, but only 6.5% of the controls (P<0.001) had a hypoechoic tissue typical of AIT; while thyroid hormone levels were normal in all subjects, PCOS patients had a higher mean TSH level (P<0.001) and a higher incidence of TSH levels above the upper limit of normal (PCOS 10.9%, controls 1.8%; P<0.001).


CONCLUSIONS
This prospective study demonstrates a threefold higher prevalence of AIT in patients with PCOS, correlated in part with an increased estrogen-to-progesterone ratio and characterized by early manifestation of the disease.
Janssen
Onno E
OE
Division of Endocrinology, Department of Medicine, University of Essen, Essen, Germany.
Mehlmauer
Nadine
N
Hahn
Susanne
S
Offner
Alexandra H
AH
Gärtner
Roland
R
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007328:Insulin / Q000097:blood; D007986:Luteinizing Hormone / Q000097:blood; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000150:complications*; D011374:Progesterone / Q000097:blood; D011446:Prospective Studies; D013739:Testosterone / Q000097:blood; D013954:Thyroglobulin / Q000378:metabolism; D013963:Thyroid Hormones / Q000097:blood; D013967:Thyroiditis, Autoimmune / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D013972:Thyrotropin / Q000097:blood; D014463:Ultrasonography
D001786:Blood Glucose; D007328:Insulin; D013963:Thyroid Hormones; D013739:Testosterone; D011374:Progesterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D013972:Thyrotropin; D013954:Thyroglobulin