title: The link between metabolic features and TSH levels in polycystic ovary syndrome is modulated by the body weight: an euglycaemic-hyperinsulinaemic clamp study.
abstract: OBJECTIVE
  To evaluate the link among thyroid function, glucose/insulin metabolism and steroid hormones in women with polycystic ovary syndrome (PCOS), and to verify if the body mass index (BMI) might influence the interplay between PCOS features and subclinical hypothyroidism (SCH).
  
  
  METHODS
  Case-control study conducted from January to December 2014.
  
  
  METHODS
  One-hundred fifty-four young women with PCOS, according to Rotterdam criteria, and 88 controls were enrolled in an academic research environment. Anthropometric evaluation, hormonal and lipid assays, oral glucose tolerance test (OGTT) and euglycaemic-hyperinsulinaemic clamp were performed. Hirsutism was assessed with the Ferriman-Gallwey (FG) score.
  
  
  RESULTS
  SCH was found in 14% of PCOS subjects and in 1% of controls (P < 0.01). In PCOS women, TSH levels were directly correlated with fasting glycaemia, but not with other hormonal and metabolic parameters. When PCOS patients were classified on the basis of BMI, TSH levels significantly correlated with insulin secretion, insulin resistance, DHEAS and cortisol levels in obese PCOS women. Inverse correlations were found between TSH and both oestradiol and SHBG in the same group. In nonobese PCOS patients, only waist-to-hip ratio values were correlated with TSH. The prevalence of SCH was not different between nonobese and obese PCOS groups (14 and 15% respectively). However, SCH was associated with higher levels of insulin, DHEAS, cortisol and FG score only in the obese subgroup.
  
  
  CONCLUSIONS
  Our data confirm that the prevalence of SCH is increased in PCOS women. The presence of SCH is associated with endocrine and metabolic imbalances of PCOS, and the excessive body weight seems to promote this interplay.
authors: Department of Obstetrics and GynaecologyUniversità Cattolica del Sacro Cuore, Roma, Italy.
authors: Valeria
authors: V
authors: Tagliaferri
authors: Department of Obstetrics and GynaecologyUniversità Cattolica del Sacro Cuore, Roma, Italy.
authors: Daniela
authors: D
authors: Romualdi
authors: Department of Obstetrics and GynaecologyUniversità Cattolica del Sacro Cuore, Roma, Italy Department of Obstetrics and GynaecologyEnte Ecclesiastico Ospedale Generale Regionale "F. Miulli", Acquaviva delle Fonti (BA), Italy.
authors: Maurizio
authors: M
authors: Guido
authors: Department of Medical SciencesDivision of Endocrinology, Università Cattolica del Sacro Cuore, Roma, Italy amancini@rm.unicatt.it.
authors: Antonio
authors: A
authors: Mancini
authors: Department of Obstetrics and GynaecologyUniversità Cattolica del Sacro Cuore, Roma, Italy.
authors: Simona
authors: S
authors: De Cicco
authors: Department of Obstetrics and GynaecologyUniversità Cattolica del Sacro Cuore, Roma, Italy.
authors: Christian
authors: C
authors: Di Florio
authors: Department of Obstetrics and GynaecologyUniversità Cattolica del Sacro Cuore, Roma, Italy.
authors: Valentina
authors: V
authors: Immediata
authors: Department of Medical SciencesDivision of Endocrinology, Università Cattolica del Sacro Cuore, Roma, Italy.
authors: Chantal
authors: C
authors: Di Segni
authors: Department of Obstetrics and GynaecologyUniversità Cattolica del Sacro Cuore, Roma, Italy.
authors: Antonio
authors: A
authors: Lanzone
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D001835:Body Weight / Q000502:physiology*; D016022:Case-Control Studies; D004958:Estradiol / Q000097:blood; D005260:Female; D015309:Glucose Clamp Technique; D005951:Glucose Tolerance Test; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000378:metabolism*; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D013972:Thyrotropin / Q000097:blood*; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D007328:Insulin; D012738:Sex Hormone-Binding Globulin; D004958:Estradiol; D013972:Thyrotropin; D006854:Hydrocortisone