Pituitary-ovarian dysfunction in women with autoimmune thyroid disease

Abstract

In recent years, an increase in the incidence of autoimmune thyroiditis has been observed in Ukraine and other countries worldwide. The aim of the study is to determine the levels of sex and gonadotropic hormones in patients with AIT and to establish links between the functional state of the thyroid gland and the pituitary-ovarian system. Materials and methods. We examined 89 patients, aged 18-42 years, with autoimmune
thyroiditis and 30 women in the control group. We determined the levels of thyroid-stimulating hormone, free thyroxine, free triiodothyronine in the blood serum, the level of antibodies to thyroperoxidase and thyroglobulin, levels of pituitary gonadotropic hormones — folliclestimulating, luteinising, prolactin, and ovarian steroid hormones — estradiol, progesterone, free testosterone and antimullerian hormone in all patients.
Results and discussion. The analysis of hormonal homeostasis in women of reproductive age with autoimmune thyroiditis showed a decrease in estradiol and progesterone levels in thyroid hypofunction. The lowest mean values of estradiol and progesterone were recorded in the group of patients with hypothyroidism and autoimmune thyroiditis. Analysis of follicle-stimulating and luteinising hormone levels showed their increase in women with AIT compared to patients in the control group. The increase in FSH and LH levels was accompanied by an increase in TSH, ATPO and ATTG. A direct, strong correlation was found between ATPO and TSH (r=0.74; p<0.05), ATTG and TSH (r=0.71; p<0.05); an inverse strong correlation was found between AMH levels and age of patients (r=-0.75; p<0.05). An inverse correlation of medium strength was found between the level of AMH and the level of ATPO (r=-0.38; p<0.05), between the level of AMH and the level of ATTG (r=-0.32; p<0.05), the level of AMH and TSH (r=-0.40; p<0.05); an inverse correlation of medium strength between the level of TSH and the level of estradiol (r=-0.49; p<0.05); inverse weak correlation between TSH level and progesterone level (r=-0.22; p<0.05); direct correlation of medium strength between TSH and prolactin (r=0.41; p<0.05). Conclusions. The results of the study demonstrate that autoimmune thyroiditis is a significant factor in the development of hypoestrogenism, which can lead to reproductive disorders. In young women, it is associated with a risk of infertility, while in older reproductive age, it is associated with the early development of menopausal syndrome. In this regard, timely diagnosis and treatment and prevention measures in women of reproductive age with AIT are of particular relevance.