Session: MON 437-470-Non-neoplastic Thyroid Disorders
Poster Board MON-443
DO HIGH ANDROGEN LEVELS PROTECT FROM HYPOTHYROIDISM? A STUDY ON WOMEN WITH PCOS, TURNER SYNDROME AND MEN AND WOMEN IN A RANDOM POPULATION SAMPLE
Kerstin Landin-Wilhelmsen1, Johanna Schmidt2, Penelope Trimpou1, Kerstin Berntorp3, Inger Bryman2, Eva Dahlgren2, Lars Wilhelmsen4
1Section for Endocrinology, Department of Internal Medicine, Sahlgrenska University Hospital at Sahlgrenska Academy, University of Gothenburg, SE-41345 Gothenburg, Sweden, 2Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, 3Section for Endocrinology, Department of Medicine, Skane University Hospital, University of Lund, Malmö, Sweden, 4Department of Internal Medicine, Sahlgrenska University Hospital at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Context: Hypothyroidism is more common in women than in men. The cause of this gender difference is unknown.
Objective: To examine whether high levels of androgens were associated with a lower prevalence of hypothyroidism in women with different gonadal states and in men, respectively.
Design: Results from three prospective studies were compared.
Setting: University hospital.
Participants: Women with PolyCystic Ovary Syndrome (PCOS) (Rotterdam criteria) by definition hyperandrogenic, women with Turners syndrome and ongoing estrogen hormone replacement therapy (HRT) in 98 %, a random population sample of women and men (the WHO MONICA Project, Gothenburg), were studied during 10-21 years of follow-up.
Main Outcome Measures: Prevalence of hypothyroidism, defined as levothyroxine replacement and/or by a TSH≥ 4.5 mU/L and levels of serum testosterone, estradiol, TSH, free T4 and thyroid peroxidase antibodies (TPO) were obtained.
Results: Hypothyroidism was less prevalent in hyperandronegic PCOS and in men compared with women in the population and with Turner syndrome, respectively. The incidence of hypothyroidism did not increase either in PCOS, with persistent hyperandrogenism, or in men during follow-up as it did in the other groups. Hypothyroidism >50 years of age was prevalent in 8% of women with PCOS, 4% in men (ns men vs PCOS), 35% of women with Turner syndrome (p=0.009 vs. PCOS) and in 16% of postmenopausal women in the population (HRT 5%) (p<0.05 vs.PCOS). Elevated TPO was similar in PCOS 20% as in women in the population 20%, but higher in women with Turner syndrome 45% (p=0.03 Turner vs PCOS ) and 7% in men (ns men vs PCOS).
Conclusion: The prevalence and incidence of hypothyroidism was lower in women with PCOS and in men compared with women in the general population and in women with Turner syndrome. This was not explained by autoimmunity. Hyperandrogenism seems to be protective for hypothyroidism.
Nothing to Disclose: KL, JS, PT, KB, IB, ED, LW
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