Features of clinical, echographic, and laboratory data in women with multiple hyperplastic processes of reproductive system organs against the background of thyroid pathology

The objective: to establish correlations between clinical, echographic, and endocrinological data in women with multiple hyperplastic processes of reproductive system organs. Materials and methods. To achieve the set goal, 74 women were examined. The main group included 54 patients with two or more hyperplastic processes of reproductive system organs (uterine fibroids, endometrial hyperplasia and polyps, adenomyosis, external genital endometriosis, fibrocystic mastopathy). The control group consisted of 20 women with an ovulatory menstrual cycle, with an average duration of 28.4 ± 0.8 days. The complex of conducted studies included clinical, echographic, and laboratory indicators. Results. In women with multiple hyperplastic processes of reproductive system organs, a relative increase in blood estradiol levels was revealed; moreover, the highest values were observed in patients with anovulation compared to the control group (298,2 ± 11.7 pmol/L; 223,5 ± 11,7 pmol/L; p < 0,05). A large number of studies confirm the presence of estrogen alpha- and beta-receptors in normal and tumorous thyroid tissue. There are also data on the stimulating effect of estrogens on tumorous and unchanged thyroid cells regardless of the thyrotropic hormone level in the blood. It is known that estradiol increases the expression of cyclin D1, which plays a key role in the regulation of the cell cycle. In addition, estradiol triggers the mitogen-activated protein kinase cascade, which plays a key role in cell proliferation and differentiation. It can be assumed that in women with relative or absolute hyperestrogenemia, thyroid tissue hyperplasia develops due to the direct effect of estrogens on their own receptors in thyrocytes. Furthermore, estrogens are capable of increasing the sensitivity of thyroid gland cells to thyroidstimulating hormone by increasing the number of thyrotropic hormone receptors. In this study, a direct dependence of the thyroid gland volume on the blood estradiol level was revealed in women with multiple hyperplastic processes of reproductive system organs. Conclusions. It should be noted that the results of this study allow considering the thyroid gland as a target organ for the influence of estrogens and linking diffuse and nodular enlargement of the thyroid gland, as well as the development of hyperplastic processes in reproductive system organs, with relative or absolute hyperestrogenemia.