title: Thyroid-stimulating Hormone and Insulin Resistance: Their Association with Polycystic Ovary Syndrome without Overt Hypothyroidism.
abstract: ObjectiveThis study analyzed the effectiveness of the thyroid-stimulating hormone (TSH) as a predictor of insulin resistance (IR) and its association with the clinical and metabolic parameters of women with polycystic ovary syndrome (PCOS) without overt hypothyroidism.Study DesignA cross-sectional study was performed. Women with PCOS and without overt hypothyroidism (n= 168) were included.MethodsReceiver operating characteristic (ROC) curve was used to determine the cut-off point for TSH that would maximize sensitivity and specificity for a diagnosis of IR using homeostatic model assessment of insulin resistance (HOMA-IR) ≥ 2.71. Clinical and metabolic parameters were compared as a function of the TSH cut-off limit and the presence of IR.ResultsThyroid-stimulating hormone ≥ 2.77 mIU/L was associated with a diagnosis of IR, with sensitivity of 47.9% and specificity of 65.3%. There were no differences in clinical, hormonal or metabolic parameters between TSH < 2.77 and TSH of 2.77 - 10 mIU/L.ConclusionIn women with PCOS without overt hypothyroidism, TSH ≥ 2.77 mIU/L is associated with IR; however, with poor sensibility, showing TSH to be a poor predictor of IR in this population. No clinical or metabolic alterations were found that would justify a change in clinical management. Thus, the IR should be investigated in all women with PCOS irrespective of TSH level.
authors.affiliation: Department of Obstetrics and Gynecology, Faculdade de Medicina da Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
authors.forename: Cristina Laguna
authors.initials: CL
authors.lastname: Benetti-Pinto
authors.affiliation: Department of Obstetrics and Gynecology, Faculdade de Medicina da Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
authors.forename: Vanessa Berini
authors.initials: VB
authors.lastname: Piccolo
authors.affiliation: Department of Obstetrics and Gynecology, Faculdade de Medicina da Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
authors.forename: Daniela Angerame
authors.initials: DA
authors.lastname: Yela
authors.affiliation: Department of Clinics, Faculdade de Medicina da Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
authors.forename: Heraldo
authors.initials: H
authors.lastname: Garmes
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000209:etiology; D007333:Insulin Resistance; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000150:complications / Q000378:metabolism*; D013972:Thyrotropin / Q000097:blood*; D055815:Young Adult
chemical_list: D013972:Thyrotropin