The median female age of this study is 29 and the range is within the reproductive age. The PCOS group tends to be overweight or obese with a higher BMI other than the control. The increase in BMI is maybe related to two causes, the first one is PCOS and the second cause may be hypothyroidism. Forty-five percent of PCOS in this study are obese. Deepa et al [6] are in coordination with these findings. They had a mean age is 26 ± 4.2 and a BMI of 29 ± 4.4 with 32% of PCOS patients are obese. Rahul et al [11] studied the correlation of thyroid dysfunction with the PCOS prevalence and found spatially hypothyroidism increased in PCOS incidence and obese women. Mayada et. al. [12] found an increase in BMIO in PCOS women.
Women with PCOS complain of many symptoms and clinical features, such as amenorrhea, hirsutism, obesity, enlarged ovaries and infertility. It is associated with increased cardiovascular disease risk factors, such as increased blood pressure, dyslipidemia, insulin resistance, and impaired glucose tolerance [13]
The clinical feature of the PCOS group of patients presented a higher incidence than the healthy women. These findings are agreed with Deepa et al. [6] who found out that 52% of patients suffer from these clinical features. The result in the current research agrees with their study as shown in table (2) and we noticed that there is an increase in testosterone and hormone levels in PCOS females rather than healthy women. Also, Najem et al. [14] reported that all PCOS women included in their study are shown hyperandrogenism clinical features.
When the thyroid analysis was investigated for PCOS women in this study, it appears that 45% had hypothyroidism and 35% out of them were shown in the TSH test. Sinha et. al. [15] showed that 27.5 % of the PCOS females had thyroid disorder where 22% of them suffering hypothyroidism. Furthermore, they reported that TSH levels in the PCOS group were significantly higher than in the control group.
Many authors studied the relationship between the metabolic analysis for PCOS women and thyroid dysfunction [6], [8], [11] and pathologies [16]–[18] such as Pinto et al. [19] who found that 19 out of 168 PCOS women had subclinical hypothyroidism and showed higher levels of cholesterol, prolactin, and LDL than the control women. Previous findings agree with our results, except that the LDL levels in PCOS women are almost similar to the healthy control levels.
The association test of TSH, T3, and T4 with parameters involved in this study shows a significance of TSH with cholesterol only. These results disagreed with Dittrich et. al. [20] who found a significant association between insulin and TSH. They reported that PCOS women with TSH less than 2.5 mIU/L had a significant alteration of metabolic condition and endocrine hormonal level.
Simona Gabers et. al., 2015 [21] performed a study on PCOS females within reproductive age correlation with Hashimoto's Thyroiditis (HT). the data are very scarce concerning clinical consequences, joint etiology, or pathogenesis. Probably, these results are a complex etiology of both PCOS and HT. there is no doubt that genetic suspectable contributes to the development of both disorders in more than 70% as shown by family and twin studies.
The diagnosis of PCOS by ultrasound (US) is not precise and dependable. Further investigations need to be performed in order to gain an accurate diagnosis. We should mention that when hypothyroidism affects PCOS women, it worsens their symptoms by lowering the level of binding globulin belongs to sex hormone, which converts the androstenedione into testosterone and aromatization to estradiol. Also, it reduces the metabolic clearance rates of androstenedione and estrone [22],[23].