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Investigation of the Relationship Between Autoimmune and Nodular Goiter in Patients with Euthyroid Polycystic Ovary Syndrome and Their Phenotypes

Horm Metab Res. 2022 Apr 13. doi: 10.1055/a-1825-0316. Online ahead of print.

ABSTRACT

Polycystic ovary syndrome (PCOS) is an endocrine disorder that frequently affects women of reproductive age. In PCOS, the incidence of thyroid diseases has increased in addition to reproductive and metabolic problems. To compare thyroid nodule, volume, autoimmunity, and thyroid function tests of euthyroid PCOS and its phenotypes. The files of 178 patients with PCOS aged 18-45 years and 92 patients with no disease who were matched for body mass index were retrospectively scanned. Women with PCOS were divided into four phenotypes, ABCD, according to the Rotterdam guideline, as determined using thyroid ultrasonography (USG) of all participants, and PCOS phenotypes, as well as thyroid-stimulating hormone (TSH), fT4, fT3 thyroid peroxidase (anti-TPO), and thyroglobulin (anti-Tg) thyroid volume, nodule number, and nodule diameter were noted. Anti-TPO titer and prevalence, fT3, and thyroid volume were higher in the PCOS group compared with the control group (p=0.004, p=0.023, p=0.001, and p=0.001, respectively) in terms of anti-Tg levels, presence of nodules, and the number of nodules. There was no statistical difference between the PCOS group and the healthy controls. The number of nodules of 1 cm and above was found to be higher only in patients with PCOS compared with the control group (p=0.018). When the phenotypes were examined, thyroid dysfunction features were found in phenotype A, which was the most prominent. Thyroid autoimmunity, thyroid volume, and the number of nodules larger than 1 cm increased in patients with PCOS compared with controls. This situation is thought to be caused by the reproductive and metabolic properties of PCOS because thyroid dysfunction was detected more in phenotype A, which is called the full phenotype. Therefore, all patients with PCOS, especially phenotype A, should be evaluated for the presence of nodules with autoimmunity using USG, even if there are no symptoms, and thyroid functions.

PMID:35419775 | DOI:10.1055/a-1825-0316

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