TSH concentration does not affect metabolic and reproductive hormones in euthyroid women with pcos

Sarantis Livadas; Nicholas Angelopoulos; Rodis Paparodis; Justyna Kuliczkowska-Płaksej; Ralitsa Robeva; Andromahi Vryonidou; Macut Jelica Bjekic; George Mastorakos; Djuro Macut

doi:10.1530/endoabs.110.P1022

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Endocrine Abstracts (2025) 110 P1022 | DOI: 10.1530/endoabs.110.P1022

ECEESPE2025 Poster Presentations Reproductive and Developmental Endocrinology (93 abstracts)

TSH concentration does not affect metabolic and reproductive hormones in euthyroid women with pcos

Sarantis Livadas ¹ , Nicholas Angelopoulos ¹ , Rodis Paparodis ¹ , Justyna Kuliczkowska-Płaksej ² , Ralitsa Robeva ³ , Andromahi Vryonidou ⁴ , Jelica Bjekic Macut ⁵ , George Mastorakos ⁶ & Djuro Macut ⁷

Author affiliations

¹Hellenic Endocrine Network, Athens, Greece; ²University of Medicine, Department of Endocrinology, Diabetology and Isotope Therapy, Wrocław, Poland; ³USHATE "Acad. Iv. Penchev", Faculty of Medicine, Medical University, Department of Endocrinology, Sofia, Bulgaria; ⁴Department of Endocrinology and Diabetes, Hellenic Red Cross Hospital, Athens, Greece; ⁵Department of Endocrinology, UMC Bežanijska kosa, Faculty of Medicine, University of Belgrade, Belgrade, Serbia; ⁶Endocrine Unit, Aretaieion University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; ⁷Clinic of Endocrinology, Diabetes and Metabolic Diseases, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

JOINT1354

Introduction: Thyroid function is central to the regulation of human metabolism and reproductive function; abnormal thyroid function tests (TFTs) have been associated with unfavourable metabolic and hormonal changes in women with PCOS. However, it is not known if slight variations in TSH concentration affect these parameters in euthyroid women with PCOS. If a significant association is present, one may suggest thyroxine treatment in this population, even with TFTs within reference values.

Subjects and Methods: Cross sectional data of 1762 European women of Caucasian origin (age: 24.57±5.54 years, BMI: 26.34±6.88 kg/m²) diagnosed with PCOS by Rotterdam criteria were analysed. All subjects had both normal TSH values (0.4-4.7 IU/ml) and either T4 or FT4 values. None of the subjects was on treatment with Thyroxine. Anthropometric parameters (age, BMI, WHR, FG Score), metabolic indices (glucose, lipids, liver function, HOMA-IR) and hormonal (gonadotropins, testosterone, SHBG, DHEAS, D4, FAI, estradiol, insulin) values were evaluated. Data were stratified by TSH values (higher or lower of 2.5IU/ml) forming two groups: Group A (TSH < 2.5 IU/ml) and Group B (TSH < 2.5 IU/ml). In addition, data were stratified according to TSH quartiles (Q1, TSH 0.4-1.5, Q2 1.5-2.5, Q3, TSH 2.5-3.5, Q4, TSH> 3.5-4.7 IU/ml).

Results: The comparison between Groups A and B reached significant difference (P < 0.05) in TSH values (1.49±0.58 vs. 3.98±0.56IU/ml) as expected. However, except for SHBG (40.78±19.55 vs.37.96±19.64 nmol/l) and DHEAS values (3.03±1.35 vs. 2.84±1.32 nmol/l), no difference was observed in any other parameter evaluated (Table 1). When data were analysed based on TSH quartiles, statistically significant differences were found between subgroups regarding LH, FSH, SHBG and DHEAS values.

Conclusions: Our findings originating from a large European PCOS cohort suggest that TSH values in euthyroid women with PCOS are not significantly associated with any metabolic and hormonal parameters except for SHBG and DHEAS. The association between TSH and these hormones warrants further evaluation but our findings advocate against thyroxine use in women with PCOS and TSH values within the reference range for metabolic or hormonal purposes.