A STUDY OF ESTIMATION OF TSH,PROLACTIN, FSH AND LH HORMONE LEVELS IN PCOS

Dr. K.Venkateswarlu 1 and Dr. A. Padmavijayasree 2 . 1. Assistant professor , Department of Biochemistry, Kurnool Medical College, Kurnool, Andhra Pradesh, India. 2. Professor and Head of Department of Biochemistry, Kurnool Medical College, Kurnool Andhra Pradesh, India ...................................................................................................................... Manuscript Info Abstract ......................... ........................................................................ Manuscript History Received: 18 August 2019 Final Accepted: 20 September 2019 Published: October 2019


ISSN: 2320-5407
Int. J. Adv. Res. 7 (10), 1365-1368 1366 abnormalities 3. On this background the aim of this study was to assess a status of TSH,PROLACTIN ,FSH AND LH Hormone in subjects with polycystic ovarian syndrome.

Study population
The study was carried out in Department of Biochemistry ,Kurnool Medical College and Department of Obstetrics & Gynaecology , Government General Hospital , Kurnool .The study period was from June 2018 to March 2019 after institutional ethical committee approval. A total of 100 patients of age group 17 -40 years were studied of which 50 were cases and 50 controls. The patients were included if they satisfied the diagnostic criteria suggested by Androgen Excess PCOS Society. And 50 age matched normal regular menstruating women were taken as controls. Exclusion criteria for cases were patients with hypothyroidism, Diabetes mellitus, Hypertension, hyperandrogenism; such as androgen secreting tumours and congenital adrenal hyperplasia, hyperprolactinemia, cardiovascular disease, hormonal contraceptives or other type of medication that may have affected lipid profile and carbohydrate metabolism, smokers or drinkers. All details of study were explained to the subject and informed consent was taken. Clinical examination was done as per the proforma.

sample collection
After overnight fasting, samples were collected in the morning on 3rd day of menses. The samples were left standing for one hour and then serum was separated by centrifugation at 3000 rpm for 10 minutes. The samples were analyzed on by Chemiluminiscence immunoassay (CLIA) method using a Beckman Coulter Access2 fully automated analyser. in Department of Biochemistry .GGH,Kurnool, for FSH, LH Prolactin and TSH levels.

Statistical analysis:-
Statistical analysis was carried out on Microsoft excel. Continuous parameters were expressed as mean ±SD was applied to the data. Pearson correlation was used to correlate LH and TSH, FSH and TSH. P value< 0.05 was considered statistically significant.

Results:-
During the 9 month study period from June 2018 to March 2019 a total of 100 patients were studied of which 50 and 50 were controls who were normal females without any diseases in age group of 17-40 years.Levels of hormones in cases and controls LH levels are significantly raised in cases with p < o.oo1.There is no significant difference between Prolactin levels in cases and controls.(p =0.2)TSH levels are significantly raised in cases with p < 0.0001.This shows that as LH increases .TSH also Increases in PCOS patients. (   human reproductive biology also reestablished the hypothesis that hypothyroidism worsens PCOS by further decreasing sex hormone binding globulin levels, increasing the conversion of androstenedione to testosterone and aromatization to estradiol and reducing the metabolic clearance rates of androstenedione and estrone. Since thyroid hormones are involved in the gonadotropin induced estradiol and progesterone secretion by human granulosa cells, hypothyroidism would interfere with ovarian function and fertility.High level of testosterone contributes to PCOS symptoms like infertility, polycystic ovaries, hirsutism, male pattern hair loss and acne 8 . Thyroid responsitivity by the ovaries could be explained by the presence of thyroid hormone receptors on human oocytes. TSH also affects estrogen metabolism, decreases the production of sex hormone binding globulin and increases free testosterone (9,10,11 This increased estrogen may increase the levels of thyroid binding globulin and mask the activity of free thyroid hormones. Thus, the clinical features of hypothyroidism overlap with features of PCOS 12 . In our study mean serum LH was significantly higher than mean serum FSH in PCOS women compared with control subjects.The ratio is more than 2.Increased LH and decreased or normal FSH are due to (a) GnRH pulsatile secretion, i.e. at hypothalamic level. (b) high estrogen environment, i.e., at pituitary level . 13 This has been also seen in other studies-Nath , et al. found raised LH/FSH ratio in 70.58% of their patients 14 .
Gulab kanwar et al studies shows that The ratio of LH/FSH was more than 2:1in cases . 15

Conclusion:-
Based on findings of our study we conclude that PCOS is associated with high incidence of thyroid disorders and disturbances in reproductive hormone. .This points towards the importance of early correction of hypothyroidism in the management of infertility associated with PCOS. All women with PCOS should have their thyroid function tests and hormonal tests evaluated thoroughly for better outcome of results.