PATHOLOGY OF THE THYROID PATIENTS WITH REPRODUCTIVE LOSSES AND ENDOMETRIUM HYPERPLASIA
DOI:
https://doi.org/10.11603/24116-4944.2021.2.12763Keywords:
endometrial hyperplasia, hypothyroidism, hormonal imbalance, dyslipidemia, insulin resistanceAbstract
The aim of the study – to investigate distinguishing features of the formation of hyperplastic processes in women of reproductive age with benign thyroid diseases and to determine the relationship between histological status and hormonal, metabolic parameters of the body in this group of patients.
Materials and Methods. There was conducted the comprehensive clinical and laboratory examination of 90 patients with infertility, aged from 25 to 45 years, with endometrial hyperplasia. Research groups were formed: group 1 consisted of 35 patients with endometrial hyperplasia with hypothyroidism, group 2 – 25 patients with hyperplasia combined with autoimmune thyroiditis. The main inclusion criteria for the comparison group was the diagnosis of endometrial hyperplasia without verification of extragenital diseases – 30 patients. The control group included 20 women – relatively healthy individuals without gynecological pathology.
Results and Discussion. Endometrial hyperplasia with uterine fibroids was 20.0 % in the group 1 and 10.0 % in group 2. Adenomyosis represented 28.3 % and 13.3 %, respectively, p <0.05. Endometrial hyperplasia and polyps were noted 1.5 times more often in the comparison group (51.7 % and 76.6 %, respectively). The thyroid dysfunction in patients with endometrial pathology is characterized by increased TSH levels, decreased T4b levels, as well as higher titers of anti-TPO, thyroglobulin antibody and low T4b, indicating desynchronization of thyroid hormones synthesis in the case of hypothyroidism and requires medical correction. The presented data on the levels of gonadotropic and steroid sex hormones in the serum show a violation of the normal secretion rate of FSH, LH and prolactin, with an increase in this parameter by 2.7 times against control (p <0.05), testosterone – 1.8 times increase, DHEA – 1.7 times increase, without significant deviations in the two main groups.
Conclusions. Data from a comprehensive examination of the thyroid gland allowed to find thyroid pathology in 67.8 %. The combination of endometrial hyperplasia and hypothyroidism is associated with comorbidity of proliferative processes (uterine fibroids, adenomyosis), with more pronounced androgenization, which contributes to the growth of insulin resistance, metabolic disorders and dyslipidemia. Deficiency of thyroid hormones in patients revealed an imbalance of gonadotropic function of the pituitary gland with a decrease in steroidogenesis and the development of luteal phase insufficiency and functional hyperprolactinemia.
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