亚临床甲状腺功能减退症对多囊卵巢综合征患者内分泌代谢特征的影响

doi:10.16352/j.issn.1001-6325.2023.04.0641

基础医学与临床 ›› 2023, Vol. 43 ›› Issue (4): 641-646.doi: 10.16352/j.issn.1001-6325.2023.04.0641

亚临床甲状腺功能减退症对多囊卵巢综合征患者内分泌代谢特征的影响

章远谋¹, 韩康¹, 夏瑞², 孙文健¹, 任晓莹², 王砚^3*

1.昆明理工大学附属医院云南省第一人民医院内分泌代谢科,云南昆明 650500;
2.云南中医药大学第一临床医学院,云南昆明 650021;
3.云南省第一人民医院昆明理工大学附属医院内分泌代谢科,云南昆明 650500

收稿日期:2022-08-15 修回日期:2022-11-13 出版日期:2023-04-05 发布日期:2023-04-03
通讯作者: ^*ayisa_wang@aliyun.com
基金资助:
云南省卫生科技计划项目(2017NS243)

Effect of subclinical hypothyroidism on endocrine and metabolic characteristics of patients with polycystic ovary syndrome

ZHANG Yuanmou¹, HAN Kang¹, XIA Rui², SUN Wenjian¹, REN Xiaoying², WANG Yan^3*

1. Department of Endocrinology and Metabolism, the Affiliated Hospital of Kunming University of Science and Technology, the First People's Hospital of Yunnan Province, Kunming 650500;
2. the First Clinical Medical College, Yunnan University of Traditional Chinese Medicine, Kunming 650021;
3. Department of Endocrinology and Metabolism, the First People's Hospital of Yunnan Province, the Affiliated Hospital of Kunming University of Science and Technology, Kunming 650500, China

Received:2022-08-15 Revised:2022-11-13 Online:2023-04-05 Published:2023-04-03
Contact: ^*ayisa_wang@aliyun.com

摘要/Abstract

摘要： 目的分析亚临床甲状腺功能减退症(SCH)对多囊卵巢综合征(PCOS)患者内分泌代谢特征的影响,并探讨促甲状腺激素(TSH)水平与各项内分泌代谢指标的相关性。方法选取2020年1月至2021年6月云南省第一人民医院内分泌代谢科门诊就诊的661例PCOS患者为研究对象,收集患者的一般资料及相关内分泌代谢指标。以TSH值4.2 mIU/L为SCH诊断截点,将PCOS患者分为SCH组和非SCH组;比较两组间内分泌代谢特征的差异;并对TSH水平与其内分泌代谢指标的相关性进行分析。结果 PCOS患者发生SCH的比例高达31.16％。伴SCH组较不伴SCH组的PCOS患者TSH、催乳素、三酰甘油显著升高,游离甲状腺素、雌二醇显著降低(P＜0.05)。TSH水平与PCOS患者游离甲状腺素呈负相关(r=-0.152,P＜0.001),与总胆固醇、三酰甘油呈正相关(r=0.133、0.111,P值分别为＜0.01、＜0.05)。结论伴SCH的PCOS患者合并其内分泌激素紊乱、血脂异常更为严重,可能会进一步加重PCOS患者心血管系统疾病的发生风险和生殖异常。建议对 PCOS患者定期进行甲状腺功能和脂质代谢的筛查,并长期随访。

关键词: 多囊卵巢综合征, 亚临床甲状腺功能减退症, 促甲状腺激素, 脂代谢异常, 胰岛素抵抗

Abstract: Objective To analyze the effect of subclinical hypothyroidism(SCH)on endocrine and metabolic characteristics of polycystic ovary syndrome(PCOS)patients, and to explore the correlation between thyroid stimulating hormone (TSH) level and various endocrine and metabolic indexes. Methods Totally 661 patients with PCOS in the outpatient Department of Endocrinology and Metabolism of the First People's Hospital of Yunnan Province from January 2020 to June 2021 were selected as the research object. The general data and related endocrine and metabolic indexes of the patients were collected. Taking the TSH value of 4.2 mIU/L as the cut-off point for the diagnosis of SCH, PCOS patients were divided into SCH group and non SCH group. The differences of endocrine and metabolic characteristics between the two groups were compared; The correlation between TSH level and its endocrine and metabolic indexes was analyzed. Results The incidence of SCH in PCOS patients was 31.16%. Compared with PCOS patients without SCH, the levels of TSH, prolactin and triglyceride in the group with SCH were significantly higher, and the levels of free thyroxin and estradiol were significantly lower (P＜0.05). TSH level was negatively correlated with free thyroxin in PCOS patients (r=-0.152, P＜0.001), and positively correlated with total cholesterol and triglycerides (r=0.133, 0.111, P＜0.01,P＜0.05, respectively). Conclusions PCOS patients with SCH have more serious endocrine hormone disorders and dyslipidemia, which may further aggravate the risk of cardiovascular diseases and reproductive abnormalities in PCOS patients. It is suggested that patients with PCOS should be screened for thyroid function and lipid metabolism regularly and followed up for a long time.

Key words: polycystic ovary syndrome, subclinical hypothyroidism, thyroid stimulating hormone, abnormal lipid metabolism, insulin resistance

中图分类号:

R588.6

章远谋, 韩康, 夏瑞, 孙文健, 任晓莹, 王砚. 亚临床甲状腺功能减退症对多囊卵巢综合征患者内分泌代谢特征的影响[J]. 基础医学与临床, 2023, 43(4): 641-646.

ZHANG Yuanmou, HAN Kang, XIA Rui, SUN Wenjian, REN Xiaoying, WANG Yan. Effect of subclinical hypothyroidism on endocrine and metabolic characteristics of patients with polycystic ovary syndrome[J]. Basic & Clinical Medicine, 2023, 43(4): 641-646.

参考文献

[1]Visser JA. The importance of metabolic dysfunction in polycystic ovary syndrome[J]. Nat Rev Endocrinol, 2021, 17: 77-78.
[2]Escobar-Morreale HF. Polycystic ovary syndrome: definition, aetiology, diagnosis and treatment[J]. Nat Rev Endocrinol, 2018,14: 270-284.
[3]章远谋,韩康,夏瑞,等. 胰高血糖素样肽-1受体激动剂治疗多囊卵巢综合征的研究进展[J]. 中国临床研究, 2021, 34: 1413-1416.
[4]Biondi B,Cappola AR,Cooper DS. Subclinical hypothyroidism: a review[J]. JAMA, 2019, 322: 153-160.
[5]Ding X,Yang L,Wang J,et al. Subclinical hypothyroidism in polycystic ovary syndrome: a systematic review and Meta-analysis[J]. Front Endocrinol (Lausanne), 2018,9: 700.doi:10.3389/fendo.2018.00700.
[6]Pergialiotis V,Konstantopoulos P,Prodromidou A,et al. MANAGEMENT OF ENDOCRINE DISEASE: the impact of subclinical hypothyroidism on anthropometric characteristics, lipid, glucose and hormonal profile of PCOS patients: a systematic review and meta-analysis[J]. Eur J Endocrinol, 2017,176: R159-R166.
[7]Rotterdam EA-SPcwg. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS)[J]. Hum Reprod, 2004, 19: 41-47.
[8]Li Y,Teng D,Ba J,et al. Efficacy and safety of long-term universal salt Iodization on thyroid disorders: epidemiological evidence from 31 provinces of mainland China[J]. Thyroid, 2020,30: 568-579.
[9]Wang X,Gao X,Han Y,et al. Causal association between serum thyrotropin and obesity: a bidirectional, mendelian randomization study[J]. J Clin Endocrinol Metab, 2021,106: e4251-e4259.
[10]van Hulsteijn LT,Pasquali R,Casanueva F,et al. Prevalence of endocrine disorders in obese patients: systematic review and meta-analysis[J]. Eur J Endocrinol, 2020, 182: 11-21.
[11]Song RH,Wang B,Yao QM,et al. The impact of obesity on thyroid autoimmunity and dysfunction: a systematic review and Meta-analysis[J]. Front Immunol, 2019, 10: 2349. doi:10.3389/fimmu.2019.02349.
[12]Ahirwar AK,Singh A, Jain A, et al. Role of sub clinical hypothyroidism in association with adiponectin levels causing insulin resistance in metabolic syndrome: a case control study[J]. Tokai J Exp Clin Med, 2017,42:96-103.
[13]Xu C,Zhou L,Wu K,et al. Abnormal glucose metabolism and insulin resistance are induced via the IRE1alpha/XBP-1 pathway in subclinical hypothyroidism[J]. Front Endocrinol (Lausanne), 2019,10: 303.doi:10.3389/fendo.2019.00303.
[14]Manolis AA,Manolis TA,Melita H,et al. Subclinical thyroid dysfunction and cardiovascular consequences: an alarming wake-up call?[J]. Trends Cardiovasc Med, 2020, 30: 57-69.
[15]Chang YC,Hua SC,Chang CH,et al. High TSH level within normal range is associated with obesity, dyslipidemia,hypertension, inflammation, hypercoagulability, and the metabolic syndrome: a novel cardiometabolic marker[J]. J Clin Med, 2019, 8.doi:10.3390/jcm8060817.
[16]Kucukler FK,Gorkem U,Simsek Y,et al. Evaluation of ovarian reserve in women with overt or subclinical hypothyroidism[J]. Arch Med Sci, 2018, 14: 521-526.

亚临床甲状腺功能减退症对多囊卵巢综合征患者内分泌代谢特征的影响

Effect of subclinical hypothyroidism on endocrine and metabolic characteristics of patients with polycystic ovary syndrome

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	赵茂宇, 李佑美, 刘焕云, 毛琦. 胰岛素抵抗标志物在动脉粥样硬化发病中的研究进展[J]. 基础医学与临床, 2022, 42(8): 1302-1305.
[2]	许晓双, 闵行, 叶月, 郭梦然, 甄东户. 碘与代谢综合征相关性的研究进展[J]. 基础医学与临床, 2022, 42(6): 979-982.
[3]	郑天圣, 佟雪巍, 张伊桐, 朱敏, 詹晓蓉. 2型糖尿病心血管并发症发病机制的研究进展[J]. 基础医学与临床, 2022, 42(5): 814-817.
[4]	李欢欢, 张玉齐, 吕海宏. 氧化应激增加多囊卵巢综合征患者心血管疾病风险的研究进展[J]. 基础医学与临床, 2022, 42(12): 1950-1954.
[5]	张蓝月, 张学东. 分泌蛋白Metrnl在不同疾病中作用的研究进展[J]. 基础医学与临床, 2022, 42(11): 1767-1770.
[6]	孙影, 董世云. 妊娠期代谢综合征对母亲健康及后代生长发育影响的研究进展[J]. 基础医学与临床, 2021, 41(10): 1518-1522.
[7]	孙家珍, 潘瑞洋, 申素芳. 宫腔灌注人绒毛膜促性腺激素改善多囊卵巢综合征患者子宫内膜容受性[J]. 基础医学与临床, 2020, 40(4): 496-500.
[8]	王雪莹, 郭薇, 谢聪聪, 姚冠峰, 郭晓丽, 和伟, 刘效群. 卵泡液促甲状腺激素水平对辅助生殖技术实验室指标的影响[J]. 基础医学与临床, 2020, 40(10): 1353-1357.
[9]	邵锐锋, 何驰华, 王莹. 戊酸雌二醇改善多囊卵巢综合征大鼠氯米芬诱导的子宫内膜容受性[J]. 基础医学与临床, 2020, 40(1): 78-82.
[10]	杨波熊婉媛铁宝霞蔡小玲哈小琴. 糖尿病与细胞焦亡[J]. 基础医学与临床, 2019, 39(7): 1061-1065.
[11]	朱伟郑世霞柯琳秋汪毅陈琼科夏道涵王红漫. SFRP5基因对小鼠肝癌细胞Hepa1-6糖代谢的影响[J]. 基础医学与临床, 2018, 38(9): 1268-1273.
[12]	邱维张薇陶建瓴王海云郑法雷李雪梅. 倍半萜内酯减轻糖尿病小鼠胰岛素抵抗及早期肾损伤[J]. 基础医学与临床, 2018, 38(9): 1292-1297.
[13]	王丽萍宋斌戴燕陈晖张真稳闫彩凤潘云龙. 多种脂源性细胞因子与2型糖尿病患者胰岛素抵抗相关[J]. 基础医学与临床, 2017, 37(9): 1247-1250.
[14]	由继君赵丹玉. 槲皮素促进软脂酸诱导EA.hy926细胞合成IRS2[J]. 基础医学与临床, 2017, 37(2): 249-250.
[15]	王晓晶聂敏孙梅励. MicroRNAs与葡萄糖稳态研究进展[J]. 基础医学与临床, 2014, 34(9): 1272-1276.