Thyroid volume as a marker of early atherosclerosis in women with PCOS: association with carotid intima–media thickness

Aim This study aimed to evaluate the determinants of thyroid volume (TV) in euthyroid women with polycystic ovary syndrome (PCOS) and to assess the association between TV and cardiovascular risk, with a particular focus on carotid intima – media thickness (CIMT).Methods This cross-sectional study included 100 participants (46 women with PCOS and 54 age-matched healthy controls). Only euthyroid participants were enrolled. TV was measured by ultrasonography, and CIMT was evaluated as a marker of early atherosclerosis. Biochemical markers were recorded. Multiple regression and receiver operating characteristic (ROC) analyses were performed.Results Women with PCOS had significantly higher TV compared to controls [13.4 ml (IQR: 9.8–17.4) vs. 11.3 ml (IQR: 9.6–12.9), p = 0.041]. TV was positively correlated with BMI (r = 0.485, p < 0.001), waist circumference (r = 0.419, p = 0.004), and HOMA-IR (r = 0.406, p = 0.005). CIMT was independently predicted by total testosterone (β = 0.296, p = 0.040), LH/FSH ratio (β = −0.398, p = 0.005) and TV (β = 0.306, p = 0.036). ROC analysis showed that TV moderately predicted elevated CIMT (AUC = 0.68; optimal cutoff =14.5 mL).Discussion TV was independently associated with CIMT in euthyroid women with PCOS, suggesting that thyroid morphology may serve as a complementary, noninvasive marker of early atherosclerotic changes.