Polycystic Ovarian Disease (PCOD) is one of the most prevalent endocrine disorders affecting women of reproductive age, with an estimated prevalence of 6–10% worldwide (1). It is characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology, leading to reproductive, metabolic, and psychological complications (2). The etiology of PCOD remains multifactorial, with genetic, environmental, and lifestyle factors contributing to its pathogenesis (3).

Thyroid dysfunction is a common endocrine disorder that frequently coexists with PCOD, potentially worsening the clinical features of the disease. Hypothyroidism, in particular, has been associated with metabolic disturbances such as insulin resistance, dyslipidemia, and obesity, all of which are commonly observed in PCOD patients (4,5). The prevalence of thyroid disorders, especially subclinical hypothyroidism, is higher among women with PCOD compared to the general population (6).

The interplay between thyroid dysfunction and PCOD is complex and not yet fully understood. Hypothyroidism may exacerbate the metabolic and reproductive abnormalities seen in PCOD through mechanisms involving altered gonadotropin secretion, increased androgen production, and insulin resistance (7,8). Moreover, both conditions share common pathophysiological pathways such as chronic low-grade inflammation, oxidative stress, and metabolic dysregulation (9).

Despite the known association between thyroid dysfunction and PCOD, there is still a lack of consensus regarding the need for routine screening of thyroid function in patients with PCOD. Early detection and management of thyroid abnormalities may play a crucial role in improving reproductive and metabolic outcomes in affected individuals (10). Therefore, this study aims to evaluate the prevalence of thyroid dysfunction in patients with PCOD and its potential impact on clinical and metabolic parameters.

Study Design and Population: A total of 100 female patients diagnosed with Polycystic Ovarian Disease (PCOD) based on the Rotterdam criteria (2003) were enrolled. The inclusion criteria were women aged between 18 and 40 years with confirmed PCOD. Patients with pre-existing thyroid disorders, those on thyroid hormone therapy, or those with chronic illnesses were excluded from the study.

Clinical Evaluation: A detailed medical history was obtained from each participant, including menstrual irregularities, infertility, weight changes, and other associated symptoms. Body Mass Index (BMI) was calculated using the formula: weight (kg) / height (m²). Clinical signs of hyperandrogenism such as hirsutism, acne, and alopecia were also recorded.

Biochemical Analysis: Blood samples were collected from all participants after an overnight fast of at least 8 hours. The collected samples were analyzed for thyroid function tests, including:

• Thyroid-Stimulating Hormone (TSH)
• Free Thyroxine (FT4)
• Free Triiodothyronine (FT3)

Standardized laboratory methods were used to assess these parameters using enzyme-linked immunosorbent assay (ELISA) kits.

Grouping of Participants: Based on thyroid function test results, participants were classified into:

• Euthyroid: Normal TSH, FT4, and FT3 levels.
• Subclinical Hypothyroidism: Elevated TSH with normal FT4 and FT3 levels.
• Overt Hypothyroidism: Elevated TSH with decreased FT4 and/or FT3 levels.
• Hyperthyroidism: Decreased TSH with elevated FT4 and/or FT3 levels.

Statistical Analysis: Data were analyzed using [mention statistical software, SPSS version 25.0. Descriptive statistics were used to summarize demographic and clinical variables. Categorical data were compared using the Chi-square test, while continuous variables were compared using the independent t-test or ANOVA as appropriate. A p-value of <0.05 was considered statistically significant.

A total of 100 female patients diagnosed with Polycystic Ovarian Disease (PCOD) were included in the study. The mean age of participants was 26.4 ± 5.2 years, with a BMI range of 22.1 to 36.4 kg/m².

Thyroid Dysfunction in PCOD Patients:

Thyroid function assessment revealed that 70 patients (70%) were euthyroid, while 25 patients (25%) exhibited subclinical hypothyroidism, 4 patients (4%) had overt hypothyroidism, and 1 patient (1%) was diagnosed with hyperthyroidism (Table 1).

Table 1: Distribution of Thyroid Dysfunction in PCOD Patients

Association of Thyroid Dysfunction with Clinical Parameters:

The comparison of clinical parameters among different thyroid status groups is summarized in Table 2. Mean BMI and insulin resistance (measured by HOMA-IR) were significantly higher in patients with subclinical and overt hypothyroidism compared to euthyroid patients (p < 0.05).

Table 2: Comparison of Clinical Parameters Among Thyroid Status Groups

(Table 2) shows that patients with subclinical and overt hypothyroidism had higher BMI and HOMA-IR levels compared to euthyroid patients (p < 0.05). Additionally, menstrual irregularities and infertility were more prevalent among patients with thyroid dysfunction.

The present study aimed to evaluate the prevalence of thyroid dysfunction among patients with Polycystic Ovarian Disease (PCOD) and its association with clinical and metabolic parameters. The findings indicate that thyroid dysfunction, particularly subclinical hypothyroidism, is common among women with PCOD.

In this study, 25% of the patients were diagnosed with subclinical hypothyroidism, while 4% had overt hypothyroidism, and 1% exhibited hyperthyroidism. These findings are consistent with previous studies reporting a higher prevalence of thyroid dysfunction, particularly subclinical hypothyroidism, in women with PCOD compared to the general population (1,2). The increased prevalence of thyroid dysfunction in PCOD patients may be attributed to overlapping pathophysiological mechanisms such as insulin resistance, obesity, and dysregulation of the hypothalamic-pituitary-thyroid (HPT) axis (3,4).

Our results demonstrated a significant association between thyroid dysfunction and increased BMI and insulin resistance, as measured by HOMA-IR. Similar findings have been reported by other researchers, indicating that hypothyroidism, even in its subclinical form, contributes to weight gain and insulin resistance in PCOD patients (5,6). Insulin resistance, a hallmark of PCOD, can impair thyroid hormone metabolism, leading to altered TSH secretion and further contributing to metabolic disturbances (7).

Furthermore, the present study found that menstrual irregularities and infertility were more prevalent in patients with thyroid dysfunction compared to euthyroid individuals. This observation is consistent with previous studies suggesting that thyroid dysfunction, particularly hypothyroidism, can affect gonadotropin secretion, leading to anovulation and menstrual irregularities (8,9). Additionally, increased TSH levels are associated with hyperandrogenism, which can exacerbate the reproductive abnormalities observed in PCOD (10).

Several studies have proposed potential mechanisms linking thyroid dysfunction and PCOD. For instance, the presence of chronic low-grade inflammation and oxidative stress in both conditions has been postulated to play a significant role in their coexistence (11,12). Moreover, altered adipokine secretion and dysregulation of leptin and insulin signaling pathways may also contribute to the increased prevalence of thyroid dysfunction in PCOD patients (13,14).

Despite the well-documented association between thyroid dysfunction and PCOD, there remains a lack of consensus regarding the routine screening of thyroid function in patients with PCOD. Some researchers advocate for regular thyroid function tests due to the high prevalence of thyroid abnormalities, while others suggest targeted screening for patients with clinical symptoms or risk factors.

The findings of this study suggest that thyroid dysfunction, particularly subclinical hypothyroidism, should be considered during the clinical evaluation of PCOD patients. Early detection and appropriate management of thyroid dysfunction may improve both metabolic and reproductive outcomes in these individuals.

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