Jan 1, 2004
PCOS, autoimmune thyroiditis link studied: thyroiditis risk up threefold - Gynecology
Damian McNamara
PALM BEACH, FLA. -- There is a high prevalence of autoimmune thyroiditis in women with polycystic ovary syndrome, according to a prospective study presented at the annual meeting of the American Thyroid Association.
The study showed a threefold higher prevalence of autoimmune thyroiditis in patients with polycystic ovary syndrome (PCOS), compared with controls. "All patients with PCOS should be screened for autoimmune thyroiditis, even without evidence of overt thyroid dysfunction," said study researcher Dr. Onno E. Janssen of the University of Essen (Germany).
Because of their anovulatory cycles, women with PCOS have an increased ratio of estrogen to progesterone. Previous research has suggested that women with this increased ratio also have a higher prevalence of autoimmune thyroiditis.
Dr. Janssen and his colleagues conducted a prospective study to further evaluate a possible association between PCOS and autoimmune thyroiditis. They assessed 175 women with PCOS and 168 age-matched control subjects. Women were said to have PCOS if they had at least two of the following: hyperandrogenemia, hirsutism, polycystic ovaries, and oligomenorrhea. Clinical diagnosis was confirmed with a biochemical test.
The PCOS group, compared with the control group, had a higher body mass index (30 vs. 25), a higher mean LH to FSH ratio (2.5 vs. 2.0), a lower mean progesterone level (1.0 [micro]g/L vs. 8.5 [micro]g/L), a higher mean testosterone level (2.6 nmol/L vs. 1.0 nmol/L), and a higher prevalence of hirsutism (83% vs. 3%).
The researchers performed thyroid antibody tests and ultrasound examinations. A total of 27% of PCOS patients had elevated thyroid peroxidase antibodies or thyroglobulin antibodies, defined as over 100 U/mL, compared with 8% of controls.
Thyroid ultrasound showed a hypoechoic pattern in 42% of PCOS patients but only 7% of controls. Hypoechoic tissue is consistent with autoimmune thyroiditis.
"There was no significant difference in thyroid volume on ultrasound," Dr. Janssen said. "Several were already on LT4 [levothyroxine] therapy because of manifest hypothyroidism."
PCOS patients positive for thyroid antibodies tended to be older than those who were antibody negative.
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PCOS, autoimmune thyroiditis link studied: thyroiditis risk up threefold 
