Institute of Maternal and Child Research, IDIMI, School of Medicine, University of Chile, Casilla 226-3, Santiago, Chile.
Hum Reprod. 2011 Oct;26(10):2861-8. doi: 10.1093/humrep/der223. Epub 2011 Jul 21.
The significance of polycystic ovarian morphology (PCOM) during adolescence is not clear. The aim of this study was to determine the relationship between PCOM and anti-Müllerian hormone (AMH), inhibin B, testosterone and insulin levels in healthy girls during the second decade of life. We also determined whether AMH could be used as a surrogate marker of PCOM during adolescence.
Seventy-four non-obese adolescents (age range: 13.5-19.75 years old) with regular menstrual cycles participated in this study. Transabdominal ultrasound and blood samples were obtained during the follicular phase.
PCOM was present in 33.8% of the subjects. Girls with PCOM had higher AMH levels than girls without PCOM (72.5 ± 6.1 versus 33.4 ± 2.6 pmol/l; P < 0.0001) and lower FSH levels (5.4 ± 0.3 versus 6.2 ± 0.2 mUI/ml; P < 0.036). Similar levels of inhibin B, androgens and LH were observed in girls with and without PCOM. PCOM prevalence and AMH levels were not associated with age (P = 0.745 and 0.2, respectively) or BMI-SDS (P = 0.951 and 0.096, respectively). AMH levels positively correlated with the of 2-5 mm follicle number. AMH levels ≥ 60.15 pmol/l had a sensitivity and specificity of 64.0 and 89.8%, respectively, to diagnose PCOM (area under the curve = 0.873).
These data confirm that PCOM in healthy non-hyperandrogenic girls with regular menstrual cycles is prevalent and is not associated with hyperandrogenism. The elevated AMH and lower FSH levels observed in healthy girls with regular menses and PCOM suggest that this ovarian pattern is secondary to a larger number of 2-5 mm follicles. An elevated AMH level is suggestive of the presence of PCOM during adolescence.
青春期多囊卵巢形态（PCOM）的意义尚不清楚。本研究旨在确定在生命的第二个十年中，健康女孩的 PCOM 与抗苗勒管激素（AMH）、抑制素 B、睾酮和胰岛素水平之间的关系。我们还确定 AMH 是否可作为青春期 PCOM 的替代标志物。
74 名非肥胖青春期少女（年龄 13.5-19.75 岁）参与了本研究。在卵泡期进行经腹超声和血样采集。
33.8%的受试者存在 PCOM。PCOM 组的 AMH 水平高于无 PCOM 组（72.5±6.1 比 33.4±2.6 pmol/L；P<0.0001），而 FSH 水平较低（5.4±0.3 比 6.2±0.2 mUI/ml；P<0.036）。有和无 PCOM 的女孩的抑制素 B、雄激素和 LH 水平相似。PCOM 的患病率和 AMH 水平与年龄（P=0.745 和 0.2）或 BMI-SDS（P=0.951 和 0.096）无关。AMH 水平与 2-5mm 卵泡数呈正相关。AMH 水平≥60.15pmol/L 诊断 PCOM 的灵敏度和特异度分别为 64.0%和 89.8%（曲线下面积=0.873）。
这些数据证实，在具有正常月经周期的非高雄激素血症健康女孩中，PCOM 很常见，且与高雄激素血症无关。在具有正常月经周期和 PCOM 的健康女孩中观察到升高的 AMH 和较低的 FSH 水平表明，这种卵巢模式是由于 2-5mm 卵泡数量增加所致。AMH 水平升高提示青春期存在 PCOM。
