Background and Objectives: Enlargement and cystic changes in ovaries of patients with longstanding overt hypothyroidism has been observed in numerous case reports. But there is limited data about the effect of subclinical hypothyroidism (SH) on ovarian volume and ovarian cyst formation. We evaluated the relationship between serum thyroid stimulating hormone (TSH) level and ovarian volume and sonographic appearance in prepubertal girls with SH.
Material and Methods: Patients who were aged between 5-10 years and diagnosed as having SH (TSH>5 µIU/L and free thyroxine (fT4) normal) and had no history of chronic disease, use of medication that can effect thyroid functions along with age matched healthy euthyroid controls were enrolled in the study. Patients that have obesity or thyroiditis were not received to study. All patients were prepubertal (Tanner stage 1 breast development). Anthropometric (body weight, height and blood pressure) and laboratory (luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol (E2) and thyroid function tests) measurements were performed. All patients underwent a detailed suprapubik pelvic ultrasonographic examination to evaluate the ovarian volume and ovarian cyst formation.
Results: Thirty-five children with SH (mean age; 7.6±1.0 years) and 50 healthy girls (mean age; 7.7±1.2 years, P=0.926) were enrolled in the study. Antropometric parameters (height-SDS, weight-SDS, body mass index (BMI), BMI-SDS) of the groups were similar (p>0.05). TSH and LH levels were significantly higher in SH group than controls (P<0.05), however there was no significant difference between the two groups in terms of sT4, FSH and E2 levels (p> 0.05). When the groups were compared in terms of ovarian volumes the right and left ovarian volume was significantly higher in the SH group (P <0.001). TSH was positively correlated with LH and ovarian volumes in patients with SH (P <0.05).
Conclusion: The results of this study showed that ovarian volumes of patients with SH were significantly greater than those with normal thyroid function. Although ovarian enlargement and cyst formation is well recognised in longstanding overt hypothyroidism, it has been shown for the first time in patients with SH.
Keywords: subclinical hypothyroidism, puberty, ovarian volume
19 - 21 Sep 2019
European Society for Paediatric Endocrinology