ORİJİNAL ARAŞTIRMALAR
Polikistik Over Sendromlu Hastalarda Subklinik Hipotiroidi Varlığının İnsülin Direnci ve Dislipidemi Üzerine Etkileri
Investigation of the Effects of Subclinic Hypothyroidism on Insulin Resistance and Dyslipidemia in Patients with Polycystic Ovary Syndrome
Received Date : 03 Apr 2023
Accepted Date : 24 May 2023
Available Online : 30 May 2023
Fatma KÜÇÜKa, Hacer Cavidan GÜLERMANa
aAnkara Bilkent Şehir Hastanesi, Kadın Hastalıkları ve Doğum Kliniği, Ankara, Türkiye
Doi: 10.24074/tjrms.2023-97209 - Makale Dili: TR
TJRMS. 2023;7(3):81-8
ÖZET
Amaç: Polikistik Over Sendromu prevalansı yüksek olan ve metabolik etkileri nedeniyle yaşam boyu takip gerektiren multisistemik bir hastalıktır.
Subklinik hipotiroidinin de PKOS’a benzer bazı metabolik riskler taşıdığı düşünülmektedir. Biz çalışmamız ile subklinik hipotiroidinin
PKOS hastalarında hormonal parametreler, lipit profili ve insülin direnci düzeyleri üzerindeki etkisini ve bunlara bağlı olarak uzun dönem metabolik
sonuçlar açısından bu hasta grubunda ek bir risk faktörü olup olmadığını incelemeyi amaçladık. Gereç ve Yöntemler: Bu çalışma bir kesitsel
vaka kontrol çalışmasıdır. Ankara Şehir Hastanesi’ne Mayıs 2021-Eylül 2021 tarihleri arasında başvuran PKOS ve subklinik hipotiroidisi
olan 18-40 yaş arası 53 kadın grup 1; PKOS olup ötiroid olan 18-40 yaş arası 53 kadın grup 2; tamamen sağlıklı olan 54 kadın kontrol grubu olarak
ele alınmıştır. Her hastanın serum TSH, T4, FSH, LH, E2, Total testosteron, AMH, Açlık glukoz, Açlık insülin, Trigliserit, Total kolesterol,
LDL, HDL, VLDL düzeylerine bakılmış, LH/FSH oranı ve HOMA-IR değerleri hesaplanmıştır. Bulgular: SCH’nin klinik tabloya eklenmesi sonucunda
açlık insülin, HOMA-IR, insülin rezistansı varlığı, AMH ve total testosteron düzeyleri anlamlı olarak etkilenmiştir. VKİ, LH, LH/FSH
oranı, trigliserid, HDL ve VLDL düzeylerinde ise PKOS’lu gruplar ile sağlıklı kontrol grubu arasında anlamlı farklar gözlenmiştir. Sonuç: Elde
ettiğimiz verilere göre; subklinik hipotiroidi TSH 2,5-4,0 mIU/L aralığında olduğunda bile, PKOS’un özellikle insülin direnci ve glukoz metabolizması
üzerindeki olumsuz etkilerini belirginleştirmektedir. Bu sonuç, subklinik hipotiroidi ve PKOS’un birlikte bulunduğu hasta popülasyonunda
ek önlemlere ve tedavi modalitelerine gereksinim olduğunu düşündürmektedir.
Anahtar Kelimeler: PKOS, subklinik hipotiroidi, insülin direnci, dislipidemi
ABSTRACT
Objective: Polycystic Ovary Syndrome is a multisystemic disease with a high prevalence and requires lifelong follow-up due to its metabolic effects.
Subclinical hypothyroidism is thought to carry some metabolic risks similar to PCOS. The co-existence of both endocrinological disorders
may increase these risks and may require changes in follow-up and treatment modalities. In our study, we aimed to examine the effect of subclinical
hypothyroidism on hormonal parameters, lipid profile and insulin resistance levels in PCOS patients and whether there is an additional
risk factor in this patient group in terms of long-term metabolic outcomes. Materials and Methods: This study was designed as a cross-sectional
case-control study consisting of three groups. Group 1 of 53 women aged 18-40 years with PCOS and subclinical hypothyroidism who applied
to Ankara City Hospital Reproductive Endocrinology Clinic between May 2021 and September 2021; 53 women aged 18-40 years with PCOS
who were euthyroid group 2; 54 completely healthy women were taken as the control group. Each patient's serum TSH, T4, FSH, LH, E2, Total
testosterone, AMH, Fasting glucose, Fasting insulin, Triglyceride, Total cholesterol, LDL, HDL, VLDL levels were checked, LH/FSH ratio and
HOMA-IR values were calculated. Results: As a result of our study, fasting insulin, HOMA-IR, presence of insulin resistance, AMH and total
testosterone levels were significantly affected. Significant differences were observed between the PCOS groups and the healthy control group in
BMI, LH, LH/FSH ratio, triglyceride, HDL and VLDL levels. Conclusion: According to the data we obtained as a result of our study; even the
TSH levels are in the range of 2.5-4.0 mIU/L, subclinical hypothyroidism highlights the negative effects of PCOS, especially on insulin resistance
and glucose metabolism. This results suggest that additional precautions and treatment modalities are needed in the patient population with
subclinical hypothyroidism and PCOS.
Keywords: PCOS, subclinical hypothyroidism, insulin resistance, dyslipidemia
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