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抗苗勒管激素:从出生到绝经后女性中与年龄、雄激素及代谢因素的相关性

Antimüllerian hormone: correlation with age and androgenic and metabolic factors in women from birth to postmenopause.

作者信息

Cui Linlin, Qin Yingying, Gao Xuan, Lu Jun, Geng Ling, Ding Lingling, Qu Zhongyu, Zhang Xiruo, Chen Zi-Jiang

机构信息

Center for Reproductive Medicine, Provincial Hospital Affiliated to Shandong University, Jinan, People's Republic of China; Key Laboratory for Reproductive Endocrinology of Ministry of Education, People's Republic of China, Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan, People's Republic of China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, People's Republic of China.

Qilu Securities Institute for Financial Studies, Shandong University, Jinan, People's Republic of China.

出版信息

Fertil Steril. 2016 Feb;105(2):481-5.e1. doi: 10.1016/j.fertnstert.2015.10.017. Epub 2015 Nov 6.

Abstract

OBJECTIVE

To study the age-specific distribution of antimüllerian hormone (AMH) and describe the association of AMH with androgenic and metabolic profiles at different ages.

DESIGN

Cross-sectional study.

SETTING

University hospital.

PATIENT(S): A total of 6,763 Chinese women from birth to menopause.

INTERVENTION(S): None.

MAIN OUTCOME MEASURE(S): Anthropometric parameters (height, weight, and blood pressure), and levels of AMH and testosterone, glucose metabolism, and lipid profiles.

RESULT(S): According to the level of AMH, four age phases were established: childhood (0-10 years), adolescence (11-18 years), reproductive age (19-50 years), and advanced age (≥51 years). During childhood and adolescence, AMH levels increased, reaching a peak at 18 years. A decline occurred thereafter during the reproductive-age period until the age of 50 years, and it remained at a low level above 0 onward. We found that AMH was negatively correlated with testosterone in childhood (r = -0.25), but was positively correlated with testosterone and the free androgen index in adolescence (r = 0.30; r = 0.26, respectively) as well as during the reproductive phases (r = 0.28; r = 0.31, respectively). No correlation was observed between AMH and body mass index, fasting blood glucose, fasting insulin, the homeostasis model assessment, total cholesterol, triglycerides, low-density lipoprotein, or high-density lipoprotein at any phase.

CONCLUSION(S): From birth to 18 years, AMH increases, then it declines thereafter, indicating changes of ovarian maintenance. A positive relationship between androgenic profiles and AMH during adolescence and reproductive years implies a synchronism between androgens and ovarian reserve.

摘要

目的

研究抗苗勒管激素(AMH)的年龄特异性分布,并描述不同年龄段AMH与雄激素及代谢指标之间的关联。

设计

横断面研究。

地点

大学医院。

患者

共纳入6763名中国女性,年龄范围从出生至绝经。

干预措施

无。

主要观察指标

人体测量参数(身高、体重和血压)、AMH和睾酮水平、糖代谢及血脂谱。

结果

根据AMH水平,划分出四个年龄阶段:儿童期(0 - 10岁)、青春期(11 - 18岁)、生育期(19 - 50岁)和老年期(≥51岁)。在儿童期和青春期,AMH水平升高,18岁时达到峰值。此后在生育期直至50岁出现下降,并从50岁起一直维持在低水平且高于0。我们发现,儿童期AMH与睾酮呈负相关(r = -0.25),但在青春期(分别为r = 0.30;r = 0.26)以及生育期(分别为r = 0.28;r = 0.31),AMH与睾酮及游离雄激素指数呈正相关。在任何阶段,均未观察到AMH与体重指数、空腹血糖、空腹胰岛素、稳态模型评估、总胆固醇、甘油三酯、低密度脂蛋白或高密度脂蛋白之间存在相关性。

结论

从出生到18岁,AMH升高,之后下降,表明卵巢储备功能发生变化。青春期和生育期雄激素指标与AMH之间的正相关关系意味着雄激素与卵巢储备之间存在同步性。

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