亚临床甲减与多囊卵巢综合征的相关性研究

Correlation between Subclinical Hypothyroidism and Polycystic Ovary Syndrome

摘要: 目的：探讨亚临床甲减(Subclinical hypothyroidism, SCH)与多囊卵巢综合征(polycystic ovary syndrome, PCOS)患者的临床和代谢指标的相关性。方法：回顾性分析2019年10月至2021年10月在我院妇科门诊就诊的18~40岁诊断为PCOS的患者共165例，分为伴SCH组40例和不伴SCH组125例。选择同期体检患者165例，分为伴SCH组36例和不伴SCH组129例即正常对照组。采用非参数检验比较TSH对以上四组的临床和代谢指标的相关性。结果：1) SCH在PCOS患者中的发生率(24.2%)高于非PCOS患者(21.8%)。2) PCOS伴SCH组的BMI、FPG、FINS、HOMA-IR、TG、TC、LDL-C、TSH高于PCOS不伴SCH组及正常对照组，HDL-C低于PCOS不伴SCH组和正常对照组(P < 0.05)。3) PCOS伴SCH组的BMI、FPG、FINS、HOMA-IR、TG、TC、LDL-C、T、TSH高于正常对照组；HDL-C低于正常对照组(P < 0.05)，而与非PCOS伴SCH组无统计学差异(P > 0.05)。4) 通过Spearman相关性分析显示PCOS组TSH与FPG (r_S = 0.312, P = 0.000)、FINS (r_S = 0.161, P = 0.039)、HOMA-IR (r_S = 0.207, P = 0.008)、TG (r_S = 0.212, P = 0.006)、TC (r^S = 0.201, P = 0.010)、LDL-C (r_S = 0.257, P = 0.001)呈正相关(P < 0.05)；与HDL-C (r_S = −0.183, P = 0.019)呈负相关(P < 0.05)。结论：SCH加重了PCOS患者的糖、脂代谢紊乱，监测PCOS患者的TSH水平对PCOS患者糖脂代谢紊乱及其导致的远期并发症具有重要意义。

Abstract: Objective: To explore the correlation between Subclinical hypothyroidism (SCH) and clinical and metabolic indexes of patients with polycystic ovary syndrome (PCOS). Methods: A total of 165 patients aged 18~40 who were diagnosed with PCOS from October 2019 to October 2021 in the gynecological clinic of our hospital were retrospectively analyzed. They were divided into two groups: 40 patients with SCH and 125 patients without SCH. 165 patients with physical examination in the same period were divided into two groups: 36 patients with SCH and 129 patients without SCH, that is, the normal control group. Nonparametric test was used to compare the correlation between TSH and the clinical and metabolic indexes of the above four groups. Results: 1) The incidence of 1)SCH in PCOS patients (24.2%) was higher than that in non-PCOS patients (21.8%). 2) BMI, FPG, FINS, HOMA-IR, TG, TC, LDL-C and TSH in PCOS with SCH group are higher than those in PCOS without SCH group and normal control group, while HDL-C is lower than that in PCOS without SCH group and normal control group (P < 0.05). 3) BMI, FPG, FINS, HOMA-IR, TG, TC, LDL-C, T and TSH in PCOS with SCH group are higher than those in normal control group; HDL-C is lower than that of the normal control group (P < 0.05), but there is no statistical difference between the two groups (P > 0.05). 4) Spearman correlation analysis showed that TSH in PCOS group was positively correlated with FPG (r_S = 0.312, P = 0.000), FINS (r_S = 0.161, P = 0.039), HOMA-IR (r_S = 0.207, P = 0.008), TG (r_S = 0.212, P = 0.008), TC (r_S = 0.201, P = 0.010) and LDL-C (r_S = 0.257, P = 0.001) (P < 0.05); there was a negative correlation with HDL-C (r_S = -0.183, P = 0.019) (P < 0.05). Conclusion: SCH aggravates the disorder of glucose and lipid metabolism in PCOS patients. Monitoring TSH level in PCOS patients is of great significance to the disorder of glucose and lipid metabolism and its long-term complications.