Department of Medical and Surgical Science, Division of Endocrinology, University Alma Mater Studiorum, Sant'Orsola-Malpighi Hospital, Via Massarenti 9, 40138 Bologna, Italy.
J Clin Endocrinol Metab. 2013 Oct;98(10):E1575-82. doi: 10.1210/jc.2013-1107. Epub 2013 Aug 8.
Antimüllerian hormone (AMH) and insulin-like factor 3 (INSL3) represent ovarian functional markers of granulosa and theca cells, respectively.
We conducted a prospective study to investigate AMH and INSL3 plasma levels in 3 groups of women with polycystic ovary syndrome (PCOS) classified according to menstrual cyclicity pattern and their relationship with ovarian morphology and hormonal levels.
AMH and INSL3 were measured in a cohort of 57 patients with PCOS, divided into 3 groups according to menstrual status: eumenorrheic (PCOS-E, n = 15), oligomenorrheic (PCOS-O, n = 25), and amenorrheic (PCOS-A, n = 17). Clinical and endocrine characteristics and ovarian morphology were compared among the groups. Twenty-seven age- and weight-matched women without hyperandrogenism were included as controls.
According to the menstrual pattern, the women with PCOS-A and PCOS-O had higher INSL3 levels with respect to the control women (P = .025 and P = .004, respectively) and higher but not significant INSL3 levels compared with those of the women with PCOS-E. AMH levels were significantly higher in women with PCOS-A and PCOS-O with respect to those in women with PCOS-E (P < .001 and P < .001, respectively) and control women (P < .001 and P < .001, respectively). Interestingly, a significant positive correlation was found between INSL3 and AMH blood levels in all women with PCOS (R = 0.43; P = .002) and across the groups (R = 0.41; P < .001).
INSL3 and AMH levels are significantly correlated with each other in women with PCOS, and they are significantly increased, particularly in the presence of amenorrhea and oligomenorrhea. INSL3 and AMH may reflect a dysfunction of PCOS thecal and granulosa cells, which are responsible for the increased androgen production and chronic anovulation of this condition.
抗缪勒管激素（AMH）和胰岛素样因子 3（INSL3）分别代表颗粒细胞和膜细胞的卵巢功能标志物。
我们进行了一项前瞻性研究，以调查根据月经周期模式分类的多囊卵巢综合征（PCOS）的 3 组妇女的 AMH 和 INSL3 血浆水平及其与卵巢形态和激素水平的关系。
在一组 57 例 PCOS 患者中测量 AMH 和 INSL3，根据月经状态将其分为 3 组：月经正常（PCOS-E，n = 15）、月经稀发（PCOS-O，n = 25）和闭经（PCOS-A，n = 17）。比较各组的临床和内分泌特征以及卵巢形态。纳入 27 名年龄和体重匹配且无高雄激素血症的妇女作为对照组。
根据月经模式，PCOS-A 和 PCOS-O 组的 INSL3 水平与对照组相比更高（P =.025 和 P =.004），与 PCOS-E 组相比也更高，但无统计学意义。PCOS-A 和 PCOS-O 组的 AMH 水平明显高于 PCOS-E 组（P <.001 和 P <.001）和对照组（P <.001 和 P <.001）。有趣的是，所有 PCOS 患者（R = 0.43；P =.002）和各组之间（R = 0.41；P <.001）均发现 INSL3 和 AMH 血液水平之间存在显著正相关。
在 PCOS 妇女中，INSL3 和 AMH 水平彼此显著相关，特别是在闭经和月经稀发时，其水平显著增加。INSL3 和 AMH 可能反映了 PCOS 颗粒细胞和膜细胞的功能障碍，这是导致该疾病雄激素产生增加和慢性无排卵的原因。
