Thyroid Stimulating Hormone Level in Polycystic Ovarian Syndrome and Its Correlation with Insulin Resistance
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Abstract
Background: Polycystic Ovarian Syndrome (PCOS) is a major endocrine ailment in reproductive-age women. It relates to female infertility, with insulin resistance (IR) considered the main factor in pathogenesis. The nature and degree of IR vary among ethnicities. Thyroid dysfunction, mainly subclinical hypothyroidism, is common in PCOS subjects and has been postulated as a determinant of IR. This study aims to estimate thyroid-stimulating hormone levels in polycystic ovarian syndrome and their association with insulin resistance.
Methods: This cross-sectional study was conducted in the Reproductive Endocrinology and Infertility OPD under the Department of Obstetrics and Gynaecology, Dhaka Medical College and Hospital, from June 2022 to May 2023. 75 diagnosed PCOS patients of reproductive age (15-40 years) were included. A 2 ml venous blood sample was taken to measure TSH and HOMA-IR. TSH was measured by Micro particle Enzyme Immunoassay (MEIA). TSH above 2.5 mIU/L was considered high. HOMA-IR measured insulin resistance. SPSS v.23 was used for analysis.
Results: Out of 75 PCOS patients, 39(52.0%) belonged to the age group 18-24 years, with a mean age of 24.7±5.2 years. Low serum TSH (≤2.5 mIU/L) was found in 37(49.3%) and high serum TSH (>2.5 mIU/L) in 38(50.7%). Mean serum TSH was 2.49±1.20 mIU/L. Serum TSH was higher in an insulin-resistant group than the non-resistant group (68.9% vs 23.3%) with an odds ratio of 7.276, 95% CI (2.532-20.906). Significant correlation (r=0.542; p=0.001) was found between serum TSH and HOMA-IR.
Conclusion: Serum TSH level is significantly elevated in PCOS patients with insulin resistance compared to those without insulin resistance.