Association between Alanine Aminotransferase and Thyroid Hormone with Obese Polycystic Ovarian Syndrome

Polycystic ovarian syndrome (PCOS) is a multifactorial endocrine disorder often accompanied by metabolic and hepatic abnormalities, particularly in obese women. This study aimed to investigate the association between alanine aminotransferase (ALT) and thyroid hormone levels in obese women with PCOS in a Bangladeshi setting. This study was a cross-sectional study; conducted among 50 obese PCOS-diagnosed women, at the Outpatient Department of Obs and Gynae, Bangladesh Medical University, Bangladesh from July 2023 and June 2024 Clinical, biochemical and ultrasonographic evaluations were performed. Serum ALT, thyroid-stimulating hormone (TSH) and free thyroxine (fT₄) levels were measured. Statistical analyses included correlation and logistic regression to identify predictors of elevated ALT (>40 U/L). Among the study population, subclinical hypothyroidism was observed in 38.0% and overt hypothyroidism in 14.0% of participants. Elevated ALT was present in 36.0% of cases. ALT levels were significantly higher in hypothyroid patients (p=0.01). Positive correlation was found between ALT and TSH (r?=?0.41, p<0.01), while ALT and fT₄ showed a negative correlation (r?=?-0.35, p<0.05). Logistic regression confirmed hypothyroidism (OR: 2.60, p=0.028), higher TSH (OR: 1.22, p=0.022) and lower fT₄ (OR: 1.29, p=0.041) as significant predictors of ALT elevation. Thyroid dysfunction, particularly hypothyroidism, is strongly associated with hepatic enzyme elevation in obese women with PCOS. Routine thyroid and liver function assessment should be considered in PCOS management to prevent progression to metabolic and hepatic complications.