Service d'Endocrinologie Moléculaire et Maladies Rares, Lyon, France.
Andrologia. 2012 Oct;44(5):349-54. doi: 10.1111/j.1439-0272.2010.01092.x. Epub 2011 Mar 25.
The aim of this study was to compare anti-Mullerian hormone (AMH) plasma levels in patients with azoospermia according to the physiopathology. In a prospective clinical study from April 2008 to March 2009 in University Hospital, we measured AMH levels in 49 consecutive patients with azoospermia. AMH plasma levels were correlated with FSH, inhibin B, bioavailable testosterone plasma levels and testicular volume and compared between nonobstructive azoospermia (NOA) and obstructive azoospermia (OA) and within four physiopathological subgroups of NOA: genetic, cryptorchidism, cytotoxic and unexplained. AMH, FSH, inhibin B, bioavailable testosterone plasma levels and testicular volumes were all related to each other. AMH plasma levels were lower in NOA relatively to OA. Lowest values were observed in cases of genetic NOA and on the other hand, the values observed in case of cytotoxic NOA were as high as the values observed in OA. FSH, inhibin B, bioavailable testosterone and testicular volume were not different between genetic and cytotoxic NOA. These results suggest that the decrease in AMH plasma levels is related to the origin of NOA, with low values in genetic NOA and values similar to OA in cytotoxic NOA. Further studies will be useful to understand the fine regulation of AMH production.
本研究旨在比较根据病理生理学，无精子症患者的抗缪勒管激素（AMH）血浆水平。在 2008 年 4 月至 2009 年 3 月在大学医院进行的前瞻性临床研究中，我们测量了 49 例连续无精子症患者的 AMH 水平。AMH 血浆水平与 FSH、抑制素 B、生物可利用睾酮血浆水平和睾丸体积相关，并在非梗阻性无精子症（NOA）和梗阻性无精子症（OA）之间以及在非梗阻性无精子症的四个病理生理亚组之间进行了比较：遗传、隐睾、细胞毒性和不明原因。AMH、FSH、抑制素 B、生物可利用睾酮和睾丸体积之间均相关。NOA 中 AMH 血浆水平较 OA 低。遗传型 NOA 中观察到的最低值，而另一方面，细胞毒性型 NOA 中观察到的 AMH 水平与 OA 中观察到的 AMH 水平一样高。遗传型和细胞毒性型 NOA 之间的 FSH、抑制素 B、生物可利用睾酮和睾丸体积没有差异。这些结果表明 AMH 血浆水平的降低与 NOA 的起源有关，遗传型 NOA 中 AMH 水平降低，而细胞毒性型 NOA 中 AMH 水平与 OA 相似。进一步的研究将有助于了解 AMH 产生的精细调节。
