Laven Joop S E, Mulders Annemarie G M G J, Visser Jenny A, Themmen Axel P, De Jong Frank H, Fauser Bart C J M
Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus Medical Center, Rotterdam, The Netherlands.
J Clin Endocrinol Metab. 2004 Jan;89(1):318-23. doi: 10.1210/jc.2003-030932.
Anti-Müllerian hormone (AMH) concentrations correlate with the number of antral follicles as well as age and constitute an endocrine marker for ovarian aging. In normogonadotropic anovulatory infertile women [World Health Organization (WHO) class 2], the number of early antral follicles is usually increased. To investigate whether AMH concentrations are increased, serum levels in 128 WHO 2 women were compared with those in 41 normoovulatory premenopausal women of similar age. Serum AMH concentrations are significantly (P < 0.001) elevated in WHO 2 patients [median, 7.6 micro g/liter (range, 0.1-40.0)], compared with controls [median, 2.1 micro g/liter (0.1-7.4)]. In 106 patients presenting with polycystic ovaries (PCOs) (>/==" BORDER="0">12 follicles/ovary measuring 2-9 mm and/or an ovarian volume > 10 ml), AMH levels were elevated [9.3 micro g/liter (1.8-40.0)], compared with 22 patients without PCOs [6.4 micro g/liter (0.1-22.1)] (P < 0.0001). In WHO 2 patients, AMH concentrations correlated with features characteristic for polycystic ovary syndrome such as LH concentrations (r = 0.331; P = 0.0001), testosterone levels (r = 0.477, P = 0.0001), mean ovarian volume (r = 0.421; P = 0.0001), and the number of ovarian follicles (r = 0.308; P = 0.0001). AMH levels correlated well with age in WHO 2 patients (r = -0.248; P = 0.002) as well as in controls (r = -0.465; P = 0.005). However, the relative decline in AMH with age is less pronounced in WHO 2 patients. In a subset of patients no significant correlation was found between AMH serum concentrations and the FSH response dose, the duration of stimulation, and the total number of ampoules of FSH used. In conclusion, serum AMH concentrations are elevated in WHO 2 women, especially in those patients exhibiting PCOs. Because AMH concentrations correlated well with other clinical, endocrine, and ultrasound markers associated with polycystic ovary syndrome, AMH may be used as a marker for the extent of the disease. A less pronounced AMH decrease over time in these women may suggest retarded ovarian aging. The latter hypothesis, however, should be confirmed by longitudinal studies.
抗苗勒管激素（AMH）浓度与窦卵泡数量以及年龄相关，是卵巢衰老的一种内分泌标志物。在正常促性腺激素性无排卵不孕女性（世界卫生组织（WHO）2类）中，早期窦卵泡数量通常增加。为了研究AMH浓度是否升高，对128名WHO 2类女性的血清水平与41名年龄相似的正常排卵绝经前女性的血清水平进行了比较。与对照组[中位数，2.1μg/升（0.1 - 7.4）]相比，WHO 2类患者的血清AMH浓度显著升高（P < 0.001）[中位数，7.6μg/升（范围，0.1 - 40.0）]。在106例患有多囊卵巢（PCOs）（≥12个卵泡/卵巢，直径2 - 9mm和/或卵巢体积>10ml）的患者中，AMH水平升高[9.3μg/升（1.8 - 40.0）]，相比之下，22例无PCOs的患者为[6.4μg/升（0.1 - 22.1）]（P < 0.0001）。在WHO 2类患者中，AMH浓度与多囊卵巢综合征的特征相关，如促黄体生成素（LH）浓度（r = 0.331；P = 0.0001）、睾酮水平（r = 0.477，P = 0.0001）、平均卵巢体积（r = 0.421；P = 0.0001）以及卵巢卵泡数量（r = 0.308；P = 0.0001）。在WHO 2类患者以及对照组中，AMH水平与年龄均有良好的相关性（WHO 2类患者中r = -0.248；P = 0.002，对照组中r = -0.465；P = 0.005）。然而，在WHO 2类患者中，AMH随年龄的相对下降不太明显。在一部分患者中，未发现AMH血清浓度与促卵泡生成素（FSH）反应剂量、刺激持续时间以及使用的FSH安瓿总数之间存在显著相关性。总之，WHO 2类女性的血清AMH浓度升高，尤其是那些患有PCOs的患者。由于AMH浓度与多囊卵巢综合征相关的其他临床、内分泌和超声标志物相关性良好，AMH可作为该疾病严重程度的标志物。这些女性中AMH随时间下降不太明显可能提示卵巢衰老延迟。然而，后一种假设应通过纵向研究来证实。
