Abstract
Objectives
Autoimmune polyglandular syndrome type 3 – (APS-3), is defined as the coexistence
of autoimmune thyroiditis with other non-ovarian autoimmune diseases without primary
adrenal insufficiency. Additionally the definition of APS-3 also includes primary
ovarian insufficiency (POI) coexistence with autoimmune thyroiditis.
The main goal of that study is to assess the prevalence of APS-3 defined as coexistence
of autoimmune thyroiditis with POI in population of 46 XX karyotype women with primary
ovarian insufficiency (POI).
The second goal is to investigate hormonal profile and insulin sensitivity in women
with POI and subgroups of women with APS-3 – POI/APS-3(+) and without APS 3 – POI/APS-3(−).
Materials and methods
Anthropometric measurements, coexistence of autoimmune diseases, androgens, fasting
glucose and insulin, glucose and insulin at 60′ and 120′ of oral glucose tolerance
test (OGTT) and homeostasis model for insulin resistance (HOMA-IR), were determine
in 98 patients aged between 18 and 39 with spontaneous 46 XX primary ovarian insufficiency
(POI), in 33 POI/APS-3(+), 65 POI/APS-3(−), and 75 healthy controls.
Results
Continuous data were summarized by the mean ± standard deviation (SD), and categorical data by number (percentages). Data were checked
for normality using Shapiro–Wilk test, the comparison between groups were performed
using non-parametric Mann–Whitney or Kruskall–Wallis test. Pearson's correlation coefficient
was used to assess the relationships between parameters. Statistical significance
was defined as p values <0.05.
Autoimmune thyroid disease (ATD) was presented in 33/98 (33.7%) patients with POI.
The groups did not differ significantly in respect to age and body mass index (BMI).
Women with POI, POI/APS-3(+) and POI/APS-3(−) showed significantly lower serum androgens
in comparison to controls. Additionally women with POI/APS-3(+) showed hyperinsulinemia
after 1 h of OGTT; No significant differences in serum fasting glucose, insulin and during
2 h OGTT between groups were observed.
Conclusions
The prevalence of APS-3 is 33.7% in patients with spontaneous 46 XX primary ovarian
insufficiency. Women with POI, POI/APS-3(+) and POI/APS-3(−) feature lower testosterone,
androstendione, dehydroepiandrostendione sulphate in comparison to controls. Women
with POI/APS-3(+) could have hyperinsulinemia and should be carefully evaluated for
metabolic disorders.
Keywords
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Article info
Publication history
Published online: May 20, 2016
Accepted:
May 13,
2016
Received in revised form:
April 25,
2016
Received:
March 9,
2016
Identification
Copyright
© 2016 Elsevier Ireland Ltd. All rights reserved.
