# Understanding the Effects of Obesity over Polycystic Ovary Syndrome by Analyzing Insulin Resistance and Thyroid Hormone in Different BMI Levels

## Authors

- Tugba Gurbuz ([ORCID](https://orcid.org/0000-0003-3555-3767)) — Medistate Hospital Gynecology and Obstetric Clinic, Istanbul, TURKEY
- Nur Dokuzeylul Gungor ([ORCID](https://orcid.org/0000-0002-7234-3876)) — Bahçeşehir Üniversitesi Göztepe Medikal Park Hastane Kopmleksi Kadın Hastalıkları ve Tüp Bebek Kliniği

## Article information

- **Journal:** The Ulutas Medical Journal (Ulutas Med J), ISSN 2149-388X
- **Issue:** Volume 7, Issue 1 (2021), pages 8–12
- **Article type:** Original Article
- **Published online:** 2021-03-23
- **DOI:** [10.5455/umj.20210108062520](https://doi.org/10.5455/umj.20210108062520)
- **Licence:** [CC BY-NC 4.0](https://creativecommons.org/licenses/by-nc/4.0/)
- **Article page:** https://www.ulutasmedicaljournal.com/?mno=41856
- **PDF:** https://www.ulutasmedicaljournal.com/pdf/41856.pdf

## Abstract

Introduction: Individuals with polycystic ovary syndrome (PCOS) tend to exhibit insulin resistance and circulating levels of insulin higher than controls matched to obesity levels. The present study aimed to evaluate the hormonal alterations through body mass index (BMI) on the relationship between insulin, insulin resistance (IR), and thyroid hormone levels in PCOS. Materials and Methods: This study is a retrospective clinical analysis study conducted at the department of gynecology and obstetrics between January 2019 and April 2020. PCOS participants were divided into two groups: 59 obese PCOS patients whose BMI value is equal and higher than 27kg/m2; 51 normal or overweight PCOS with BMI less than 27kg/m2. Results: Age factor did not differ between groups (29.8±6 vs 31±7.2; p=0.345). In hormone tests, insulin (14.2±6.8 vs 14.8±8; p=0.688), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) (3.1±1.4 vs 3.4±1.8; p=0.344), thyroxine (T4)(1.2±0.5 vs 1.2±0.4) and thyroid-stimulating hormone (TSH)(1.9±1.2 vs 1.8±0.9; p=0.848) levels did not differ for BMI groups (p>0.05). Because there was no difference in laboratory comparison for any parameter we analyzed, we could not perform multivariate analysis for further investigations in terms of BMI factor. In the hematological analysis, we did not see any significant alteration for groups. Conclusion: We did not observe any difference between thyroid and IR in the patients who were grouped according to the BMI. PCOS and obesity may be directly related to hormonal interaction rather than adipose tissue.

## Keywords

Polycystic ovary syndrome; obesity; BMI; thyroid hormone

## How to cite

Gurbuz T, Gungor ND. Understanding the Effects of Obesity over Polycystic Ovary Syndrome by Analyzing Insulin Resistance and Thyroid Hormone in Different BMI Levels. Ulutas Med J. 2021;7(1):8-12. doi:10.5455/umj.20210108062520

## References

1. Brenta G. Why Can Insulin Resistance Be a Natural Consequence of Thyroid Dysfunction? Journal of Thyroid Research. 2011;2011:1-9 https://doi.org/10.4061/2011/152850
2. Ganie MA, Laway BA, Wani TA, Zargar MA, et al. Association of subclinical hypothyroidism and phenotype, insulin resistance, and lipid parameters in young women with polycystic ovary syndrome. Fertility and Sterility. 2011;95(6):2039-43 https://doi.org/10.1016/j.fertnstert.2011.01.149
3. Ehrmann DA, Liljenquist DR, Kasza K, Azziz R, Legro RS. Prevalence and Predictors of the Metabolic Syndrome in Women with Polycystic Ovary Syndrome. The Journal of Clinical Endocrinology & Metabolism. 2006;91(1):48-53 https://doi.org/10.1210/jc.2005-1329
4. Moran C, Arriaga M, Rodriguez G, Moran S. Obesity Differentially Affects Phenotypes of Polycystic Ovary Syndrome. International Journal of Endocrinology. 2012;2012:1-7 https://doi.org/10.1155/2012/317241
5. Lizcano F, Rodríguez JS. Thyroid hormone therapy modulates hypothalamo- pituitary-adrenal axis. Endocrine Journal. 2011;58 (2):137-42 https://doi.org/10.1507/endocrj.k10e-369
6. Pasquali R, Gambineri A, Pagotto U. Review article: The impact of obesity on reproduction in women with polycystic ovary syndrome. BJOG: An International Journal of Obstetrics & Gynaecology. 2006;113(10):1148-59 https://doi.org/10.1111/j.1471-0528.2006.00990.x
7. Rotondi M, Cappelli C, Magri F, Botta R, et al. Thyroidal effect of metformin treatment in patients with polycystic ovary syndrome. Clinical Endocrinology. 2011;75(3): 378-81 https://doi.org/10.1111/j.1365-2265.2011.04042.x
8. Ho CW, Chen HH, Hsieh MC, Chen CC, Hsu SP, Yip HT, et al. Increased Risk of Polycystic Ovary Syndrome and It's Comorbidities in Women with Autoimmune Thyroid Disease. International journal of environmental research and public health. 2020;17(7) https://doi.org/10.3390/ijerph17072422
9. Chen HH, Chen CC, Hsieh MC, Ho CW, Hsu SP, Yip HT, et al. Graves' disease could increase polycystic ovary syndrome and comorbidities in Taiwan. Current medical research and opinion. 2020;36(6):1063-7 https://doi.org/10.1080/03007995.2020.1756235
10. Rochon C, Tauveron I, Dejax C et al. Response of glucose disposal to hyperinsulinaemia in human hypothyroidism and hyperthyroidism. Clinical Science. 2003;104(1):7 https://doi.org/10.1042/cs20020154
11. Benetti-Pinto CL, Berini Piccolo VRS, Teatin Juliato CR. Subclinical hypothyroidism in young women with polycystic ovary syndrome: an analysis of clinical, hormonal, and metabolic parameters. Fertility and Sterility. 2013;99(2):588-92 https://doi.org/10.1016/j.fertnstert.2012.10.006
12. Biondi B, Cooper DS. The Clinical Significance of Subclinical Thyroid Dysfunction. Endocrine Reviews. 2007;29(1):76-131 https://doi.org/10.1210/er.2006-0043
13. Lupoli R, Di Minno A, Tortora A, Ambrosino P, Arianna Lupoli G, Di Minno MND. Effects of Treatment With Metformin on TSH Levels: A Meta-analysis of Literature Studies. The Journal of Clinical Endocrinology & Metabolism. 2014;99(1):E143-E8 https://doi.org/10.1210/jc.2013-2965
14. Celik C, Abali R, Tasdemir N, Guzel S, Yuksel A, Aksu E, et al. Is subclinical hypothyroidism contributing dyslipidemia and insulin resistance in women with polycystic ovary syndrome? Gynecological Endocrinology. 2012;28(8):615-8 https://doi.org/10.3109/09513590.2011.650765
15. Muderris II, Boztosun A, Oner G, Bayram F. Effect of thyroid hormone replacement therapy on ovarian volume and androgen hormones in patients with untreated primary hypothyroidism. Annals of Saudi Medicine. 2011;31(2):145-51 https://doi.org/10.4103/0256-4947.77500
16. Morteza Taghavi S, Rokni H, Fatemi S. Metformin decreases thyrotropin in overweight women with polycystic ovarian syndrome and hypothyroidism. Diabetes and Vascular Disease Research. 2011;8(1):47-8 https://doi.org/10.1177/1479164110391917
