Publication:

Thyroid dysfunction and autoimmune thyroid disease in women with polycystic ovarian syndrome: a case-control study

Background Polycystic ovarian syndrome (PCOS) is one of the most prevalent endocrine disorders affecting women of reproductive age. It is a multifactorial condition characterized by chronic anovulation, hyperandrogenism, and polycystic ovarian morphology. Emerging evidence suggests a link between PCOS and thyroid dysfunction, indicating shared pathophysiological and possibly autoimmune mechanisms. The main objective was to determine the prevalence of thyroid dysfunction and thyroid autoimmunity in women with PCOS and evaluate their association with clinical, metabolic, and endocrine parameters.

Methods This hospital-based case–control study consisted of 126 women, comprising 63 cases diagnosed with PCOS and 63 age- and parity-matched healthy controls. Clinical, biochemical, and hormonal parameters were evaluated, including thyroid function tests (TSH and FT4), anti-thyroid peroxidase antibodies (anti-TPO), lipid profile, glucose metabolism, and gonadotropin levels. Data were analysed using SPSS version 20, with p<0.05 considered statistically significant.

Results Thyroid dysfunction was significantly higher among PCOS women (26.98%) than controls (7.9%) (p=0.015). Subclinical hypothyroidism was the most frequent thyroid disorder (23.8% vs 7.9%). Anti-TPO antibody positivity was observed in 15.9% of PCOS women compared to 1.6% of controls (p=0.005). PCOS participants had higher BMI, triglycerides, total cholesterol, fasting glucose, HbA1c, LH and LH/FSH ratio, and free testosterone levels than controls.

Conclusions Thyroid dysfunction and autoimmunity are significantly more prevalent among women with PCOS and appear to contribute to the metabolic and hormonal derangements characteristic of the syndrome. Routine screening for thyroid function and autoimmunity should be integral to the clinical evaluation and management of PCOS.