Is there association between thyroid stimulating hormone levels and the four phenotypes in polycystic ovary syndrome?

OBJECTIVES: The aim of this study was to determine whether the incidence of subclinical hypothyroidism (SCH) is higher in polycystic ovary syndrome (PCOS) group than the control group. Additionally, the study investigated whether serum thyroid stimulating hormone (TSH) level is associated with various clinical parameters of PCOS regarding different phenotypes of the disease. MATERIAL AND METHODS: This retrospective, case-control study included 329 PCOS patients and 162 control women who were aged between 20 and 42 years and visited the Gynecology outpatient clinic in Pusan National University Hospital from January 2014 to December 2017. PCOS patients were further classified according to their phenotypes: phenotype A as the combination of all hyperandrogenism (HA), ovulatory dysfunction (OD), and polycystic ovarian morphology (PCOM); phenotype B as the combination of HA and OD; phenotype C as the combination of HA and PCOM; and finally, phenotype D as the combination of OD and PCOM. Laboratory blood tests included follicle stimulating hormone (FSH), luteinizing hormone (LH), TSH and anti-mullerian hormone (AMH). The ovarian volume was calculated using three diameters by gynecologic ultrasonography. RESULTS: Serum TSH level was significantly higher in PCOS patients than in the control group after adjusting for age and body mass index (BMI). Serum TSH level was not related to HA and OD, but its significant association with PCOM was confirmed in comparative analysis in quartiles. The proportion of phenotype A patients increased as serum TSH level increased, while the proportion of phenotype B and D decreased. Phenotype C stayed relatively consistent with varying TSH levels. CONCLUSIONS: More numbers of patients showed elevated TSH level satisfying SCH diagnosis in PCOS group than the control group. In addition, a significant correlation between serum TSH level and different PCOS phenotypes has been observed; especially, PCOS patients with phenotype A, which displays all of HA, OD, and PCOM, tended to have the higher TSH levels than the PCOS patients with other phenotypes, requiring proper and thorough evaluation for potential endocrine disparity and according to management in such patient group.

Alterations in transcranial Doppler indices of pregnant women with complicated preeclampsia.

OBJECTIVES: We aimed to investigate alterations in transcranial Doppler indices (TCD) of the cerebral arteries between normotensive and preeclampsia (PE) pregnancies according to the presence of cerebral symptoms. STUDY DESIGN: This cross-sectional study included 48 PE and 20 normotensive pregnancies, respectively. Doppler indices of the anterior, middle, and posterior cerebral arteries (ACA, MCA, and PCA, respectively) were compared between the PE and normotensive group. MAIN OUTCOME MEASURES: Mean cerebral velocity (MCV), pulsatility index (PI), and resistance index (RI) were calculated using cerebral velocities. The cerebral perfusion pressure (CPP), resistance area product (RAP), and cerebral flow index (CFI) were computed using velocity and blood pressure. The PE group was subdivided according to the presence of cerebral symptoms and the TCD indices were compared between these groups. RESULTS: MCV and CFI of the PCA as well as CPP and RAP of all arteries were significantly higher, while PI and RI were significantly lower in PE group (P < 0.05). PI of the MCA had the highest sensitivity (91.7%), while PI of the PCA and RAP of the MCA had the highest specificity (95.0% each) for predicting PE-related cerebral complications. The positive likelihood ratio was highest in PI of the PCA (14.58). Among these parameters, CPP and RAP of the PCA were higher in PE patients showing cerebral symptoms than in those without symptoms. CONCLUSIONS: These results suggest that pregnant women with PE had altered TCD indices and that prominent changes, thereof, especially in the PCA, contribute to the development of cerebral symptoms.

Predictive Value of Lipid Accumulation Product, Fatty Liver Index, Visceral Adiposity Index for Metabolic Syndrome According to Menopausal Status.

BACKGROUND: The aim of this study is to investigate the value of clinical indicators of metabolic syndrome according to menopausal status in healthy Korean women. METHODS: The study included 3936 female patients who were managed at Pusan National University Hospital Health Promotion Center from 2008 to 2014. Each patient completed self-report questionnaires and underwent personal interviews with a healthcare provider to assess their past medical history such as any previous disease, medication and/or menstrual histories along with the measurement of her current body size. Lipid accumulation product (LAP), fatty liver index (FLI), visceral adiposity index (VAI), other anthropometric measurements, and laboratory results were evaluated regarding the patient's diagnostic status of metabolic syndrome and menopause. RESULTS: The prevalence of metabolic syndrome was 11.6% and that of premenopausal and postmenopausal group were 7.0% and 14.6%, respectively. By univariate analysis, the area under the curve of the receiver operating characteristic curve of LAP, VAI, and FLI were 0.93, 0.93, and 0.93, respectively, in premenopausal group, and they were decreased in postmenopausal group, with the value of 0.89, 0.89, and 0.88, respectively. CONCLUSION: This study showed the predictive values of LAP, VAI, and FLI for metabolic syndrome upon the patient's status of menopause-such markers should be carefully applied in women of menopausal transition.