Sahmay Sezai, Aydin Yavuz, Oncul Mahmut, Senturk Levent M
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, Cerrahpasa School of Medicine, Istanbul University, Kizilelma Caddesi, No: 35/1, Fatih, 34300, Istanbul, Turkey,
J Assist Reprod Genet. 2014 Feb;31(2):213-20. doi: 10.1007/s10815-013-0149-0. Epub 2013 Dec 18.
We assessed the utility of using anti-Müllerian hormone (AMH) and clinical features of polycystic ovary syndrome (PCOS), polycystic ovarian morphology (PCOM), oligo/amenorrhea (OA), and hyperandrogenism (HA) for diagnosing PCOS, and compared their diagnostic accuracy with those of classical diagnostic systems.
A total of 606 females were admitted to a university hospital with menstrual irregularities or symptoms of hyperandrogenism were enrolled in this cross-sectional study. Fasting blood samples were collected. Pelvic and/or abdominal ultrasonography and clinical examination were performed. Patients were evaluated for the presence of PCOS according to conventional diagnostic criteria. The diagnostic performance of using serum AMH levels alone and in various combinations with the clinical features of PCOM, OA, and HA were investigated.
For the diagnosis of PCOS, the combination of OA and/or HA with AMH showed 83% sensitivity and 100% specificity according to the Rotterdam criteria; 83% sensitivity and 89% specificity according to the National Institutes of Health (NIH) criteria; and 82% sensitivity and 93.5% specificity according to the Androgen Excess Society (AES) criteria.
The serum AMH level is a useful diagnostic marker for PCOS and is correlated with conventional diagnostic criteria. The combination of AMH level with OA and/or HA markedly increased the clinical scope for PCOS diagnosis and can be introduced as a possible objective criterion for the diagnosis of this disease.
我们评估了使用抗苗勒管激素（AMH）以及多囊卵巢综合征（PCOS）的临床特征、多囊卵巢形态（PCOM）、月经稀发/闭经（OA）和高雄激素血症（HA）来诊断PCOS的效用，并将它们的诊断准确性与经典诊断系统的准确性进行比较。
共有606名因月经不规律或高雄激素血症症状而入住大学医院的女性参与了这项横断面研究。采集空腹血样。进行盆腔和/或腹部超声检查以及临床检查。根据传统诊断标准对患者是否存在PCOS进行评估。研究了单独使用血清AMH水平以及将其与PCOM、OA和HA的临床特征进行各种组合时的诊断性能。
对于PCOS的诊断，根据鹿特丹标准，OA和/或HA与AMH的组合显示出83%的敏感性和100%的特异性；根据美国国立卫生研究院（NIH）标准，敏感性为83%，特异性为89%；根据雄激素过多协会（AES）标准，敏感性为82%，特异性为93.5%。
血清AMH水平是PCOS的一种有用诊断标志物，并且与传统诊断标准相关。AMH水平与OA和/或HA的组合显著扩大了PCOS诊断的临床范围，可作为诊断该疾病的一种可能的客观标准引入。
