Association of LH/FSH Ratio with Thyroid Stimulating Hormone and Prolactin Levels in Women with Polycystic Ovarian Syndrome in Pakistan

Article Information

Title: Association of LH/FSH Ratio with Thyroid Stimulating Hormone and Prolactin Levels in Women with Polycystic Ovarian Syndrome in Pakistan

Authors: Sagheera Anjum Munaver, Fatima Zahra, Farzana Azhar, Quratul Aman Siddiqui

Journal: Journal of the Dow University of Health Sciences (JDUHS)

HEC Recognition History

Category	From	To
Y	2024-10-01	2025-12-31
Y	2023-07-01	2024-09-30
Y	2022-07-01	2023-06-30
Y	2021-07-01	2022-06-30
Y	2020-07-01	2021-06-30

Publisher: DOW University of Health Sciences, Karachi

Country: Pakistan

Year: 2023

Volume: 17

Issue: 1

Language: English

DOI: 10.36570/jduhs.2023.1.1636

Keywords: PCOSProlactinLH/FSH ratioTSH

Abstract

Objective: The aim of our study is to find the association of Luteinizing Hormone/Follicle Stimulating Hormone ratio (LH/FSH ratio) with Thyroid Stimulating Hormone (TSH) and prolactin levels in women with Polycystic Ovarian Syndrome (PCOS).Methods: An observational cross-sectional study was conducted in the gynecology and endocrine outpatient departments of Darul Sehat hospital from March to December 2019. The demographic data were noted, and lab investigations were done on 2nd and 3rd day of menstrual cycle. All cases were divided into 2 groups, one with LH/FSH ratio ≤2 and other &gt;2. All females of reproductive age 15-44 years who were diagnosed with PCOS according to Rotterdam criteria were included. Results: Of 130 women, the mean age was 26.16 ± 5.81 years. There were 103 (79.2%) women found with LH/FSH ≤ 2 and 27 (20.8%) with LH/FSH &gt; 2. Mean difference of TSH was found significantly higher in PCOS women with LH/FSH &gt; 2 as compared to LH/FSH ≤ 2 i.e., 3.74 ± 6.49 vs. 2.32 ± 1.54 respectively (p-value 0.049). While an insignificant mean difference of PCOS with LH/FSH was found with prolactin (p-value 0.536) and insulin (p-value 0.902). A significantly weak positive correlation of prolactin was found with LH/FSH ratio (r: 0.191, p-value 0.029).Conclusion: A significant correlation was found between LH/FSH ratio and TSH levels in women with PCOS which justifies the need for further evaluation. Therefore, thyroid function should be assessed in women with PCOS with raised LH/FSH ratio which would help in management.

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Research Objective

To find the association of Luteinizing Hormone/Follicle Stimulating Hormone ratio (LH/FSH ratio) with Thyroid Stimulating Hormone (TSH) and prolactin levels in women with Polycystic Ovarian Syndrome (PCOS).

Methodology

An observational cross-sectional study conducted in gynecology and endocrine outpatient departments. 130 women diagnosed with PCOS according to Rotterdam criteria, aged 15-44 years, were included. Participants with diabetes and known thyroid disorders were excluded. Blood samples were collected on the 2nd or 3rd day of the menstrual cycle for hormonal analysis (LH, FSH, TSH, Prolactin, Insulin, Testosterone). Participants were divided into two groups based on LH/FSH ratio: ≤2 and >2. Data analysis involved independent t-tests and Pearson correlation.

Methodology Flowchart

                        graph TD
    A["Recruit PCOS Patients 15-44 yrs"] --> B["Apply Rotterdam Criteria"];
    B --> C["Exclude Diabetes/Thyroid Disorders"];
    C --> D["Collect Blood Samples 2nd/3rd Cycle Day"];
    D --> E["Measure Hormonal Levels LH, FSH, TSH, Prolactin, Insulin, Testosterone"];
    E --> F["Categorize by LH/FSH Ratio ≤2 vs. >2"];
    F --> G["Perform Statistical Analysis t-test, Correlation"];
    G --> H["Analyze Results"];

Discussion

The study found a significant correlation between LH/FSH ratio and TSH levels in women with PCOS, suggesting that thyroid function should be assessed in these patients, especially those with a raised LH/FSH ratio. The association with prolactin was not significant in this cohort. The prevalence of menstrual irregularities was high (77.7%) in the study population.

Key Findings

A significantly higher mean difference of TSH was found in PCOS women with LH/FSH > 2 (3.74 ± 6.49) compared to those with LH/FSH ≤ 2 (2.32 ± 1.54) (p-value 0.049). An insignificant mean difference was found for prolactin (p-value 0.536) and insulin (p-value 0.902) between the groups. A significantly weak positive correlation was found between prolactin and LH/FSH ratio (r: 0.191, p-value 0.029).

Conclusion

A significant correlation exists between the LH/FSH ratio and TSH levels in women with PCOS. This finding supports the need for thyroid function assessment in PCOS patients with elevated LH/FSH ratios to aid in management.

Fact Check

* The study included 130 women.
* The mean age of the participants was 26.16 ± 5.81 years.
* A significant difference in TSH levels was observed between PCOS women with LH/FSH > 2 and LH/FSH ≤ 2 (p-value 0.049).

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