Department of Endocrinological Gynecology, Medical University of Silesia, Katowice, Poland.
Eur J Obstet Gynecol Reprod Biol. 2011 Oct;158(2):254-9. doi: 10.1016/j.ejogrb.2011.06.006. Epub 2011 Jul 12.
The aim of the study was to analyze interrelation between AMH levels and body weight, metabolic, and hormonal status in normal and overweight weight women with and without polycystic ovary syndrome (PCOS).
Eighty-seven women (54 normal weight and 33 overweight) diagnosed with PCOS and 50 apparently healthy women - Non-PCOS (28 normal weight and 22 overweight) were enrolled. The body weight and height were measured and BMI was calculated. In addition to serum glucose, lipids, androgens, FSH, LH, SHBG and insulin, AMH were assessed in fasting state and free androgens index (FAI) was calculated. The insulin resistance was assessed based on the homeostasis model of assessment-insulin resistance (HOMA-IR).
Plasma AMH levels were similar in normal weight and overweight PCOS groups (9.6±3.5 vs. 11.2±4.5ng/mL, respectively), and as expected markedly higher than in both Non-PCOS groups (2.5±0.8 and 2.3±0.7ng/mL, respectively). There were no correlations between BMI and AMH levels in all study groups. A significant positive correlation between HOMA-IR, free testosterone concentrations or FAI and AMH levels were found (R=0.31, p<0.001; R=0.91, p<0.001 and R=0.62, p<0.001, respectively). Moreover, there was positive correlation between total or LDL cholesterol and AMH levels (R=0.22, p<0.05 and R=0.31, p<0.05, respectively) and a negative one between HDL cholesterol and AMH levels (R=-0.17, p<0.05) in all study subjects.
The plasma AMH level is associated with insulin resistance but not with BMI per se. Increased circulating AMH level seems to reflect the disturbances of gonadotrophins release in PCOS. It seems that AMH level may be used not only as new surrogate marker of ovarian hyperandrogenism in PCOS but also as a potential new cardiovascular risk factor.
本研究旨在分析血清抗缪勒管激素（AMH）水平与体重、代谢和激素状态之间的关系，比较正常体重和超重的多囊卵巢综合征（PCOS）患者与非 PCOS 患者之间的差异。
共纳入 87 名 PCOS 患者（54 名正常体重和 33 名超重）和 50 名非 PCOS 健康对照者（28 名正常体重和 22 名超重）。测量体重、身高并计算体重指数（BMI）。所有受试者均检测空腹血糖、血脂、雄激素、促卵泡生成素（FSH）、促黄体生成素（LH）、性激素结合球蛋白（SHBG）和胰岛素水平，并计算游离雄激素指数（FAI）。胰岛素抵抗采用稳态模型评估-胰岛素抵抗（HOMA-IR）进行评估。
正常体重 PCOS 组和超重 PCOS 组的血清 AMH 水平相似（分别为 9.6±3.5 和 11.2±4.5ng/ml），均显著高于非 PCOS 组（分别为 2.5±0.8 和 2.3±0.7ng/ml）。在所有研究组中，BMI 与 AMH 水平均无相关性。HOMA-IR、游离睾酮浓度或 FAI 与 AMH 水平呈显著正相关（R=0.31，p<0.001；R=0.91，p<0.001；R=0.62，p<0.001）。此外，在所有研究对象中，总胆固醇或 LDL 胆固醇与 AMH 水平呈正相关（R=0.22，p<0.05；R=0.31，p<0.05），而高密度脂蛋白胆固醇与 AMH 水平呈负相关（R=-0.17，p<0.05）。
血清 AMH 水平与胰岛素抵抗相关，而与 BMI 本身无关。循环 AMH 水平升高可能反映了 PCOS 患者促性腺激素释放的紊乱。AMH 水平不仅可作为 PCOS 患者卵巢高雄激素血症的新替代标志物，也可能成为新的心血管危险因素。
