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基于2012年中国多囊卵巢综合征诊断标准的血清抗苗勒管激素在多囊卵巢综合征诊断中的初步研究

[A pilot study of serum anti-Mullerian hormone in diagnosis of polycystic ovary syndrome based on 2012 Chinese polycystic ovary syndrome diagnosis criteria].

作者信息

Yang Shiyuan, Ruan Jie, Huang Wei, Tan Jing, Zhang Xianghui, Feng Xue, Liu Dong, Fu Jing, Zhou Lu, Zhou Min

机构信息

Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu 610041, China.

Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu 610041, China; Email:

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2015 Nov;50(11):819-24.

Abstract

OBJECTIVE

Based on 2012 Chinese polycystic ovary syndrome (PCOS) diagnosis criteria, we detect the serum anti-Müllerian hormone (AMH) levels in PCOS patients, to evaluate the diagnosis value of AMH for PCOS.

METHODS

Totally 217 PCOS patients were chosen as study group and 204 non-PCOS women were as controls. Their clinical information (body weight, score for acne and hirsutism), ultrasonography for ovarian volume and the number of small follicle, and blood sample detected for hormonal and metabolic parameters were obtained. Spearman's analysis and the receiver operating characteristic curve (ROC curve) were used to assess relevance and the diagnostic efficiency of AMH in PCOS.

RESULTS

Serum AMH level was significantly higher in PCOS group compared with the control group (105.46 versus 26.28 pmol/L, P<0.01). Serum AMH were positively related to Ferriman and Gallwey (F-G) score (r=0.526, P<0.01), global acne grading system (GAGS) score (r=0.359, P<0.01), total testosterone (r=0.514, P<0.01), LH/FSH ratio (r=0.542, P<0.01), fasting plasma glucose (r=0.373, P<0.01), fasting insulin (r=0.168, P=0.008), homeostasis model assessment for insulin resistance (HOMA-IR) index (r=0.182, P=0.004), total cholesterol (r=0.247, P<0.01), triglyceride (r=0.235, P<0.01), total ovarian volume (r=0.204, P=0.008), and mean number of small follicle (r=0.693, P<0.01). The area under the ROC curve for PCOS diagnosed by AMH was 0.954 (P<0.01). the threshold of AMH for PCOS diagnosis was 57.76 pmol/L, diagnostic efficiency was high (sensitivity 95.1%, specificity 89.3%).

CONCLUSION

Based on 2012 Chinese PCOS diagnosis criteria, serum AMH level elevated in PCOS, and correlated with women's hormonal imbalance and abnormal follicular development.

摘要

目的

基于2012年中国多囊卵巢综合征(PCOS)诊断标准,检测PCOS患者血清抗苗勒管激素(AMH)水平,以评估AMH对PCOS的诊断价值。

方法

选取217例PCOS患者作为研究组,204例非PCOS女性作为对照组。获取她们的临床信息(体重、痤疮和多毛评分)、卵巢体积和小卵泡数量的超声检查结果,以及检测激素和代谢参数的血样。采用Spearman分析和受试者操作特征曲线(ROC曲线)评估AMH在PCOS中的相关性和诊断效率。

结果

PCOS组血清AMH水平显著高于对照组(105.46对26.28 pmol/L,P<0.01)。血清AMH与费里曼和高尔韦(F-G)评分(r=0.526,P<0.01)、全球痤疮分级系统(GAGS)评分(r=0.359,P<0.01)、总睾酮(r=0.514,P<0.01)、LH/FSH比值(r=0.542,P<0.01)、空腹血糖(r=0.373,P<0.01)、空腹胰岛素(r=0.168,P=0.008)、胰岛素抵抗稳态模型评估(HOMA-IR)指数(r=0.182,P=0.004)、总胆固醇(r=0.247,P<0.01)、甘油三酯(r=0.235,P<0.01)、卵巢总体积(r=0.204,P=0.008)和小卵泡平均数量(r=0.693,P<0.01)呈正相关。AMH诊断PCOS的ROC曲线下面积为0.954(P<0.01)。PCOS诊断的AMH阈值为57.76 pmol/L,诊断效率高(敏感性95.1%,特异性89.3%)。

结论

基于2012年中国PCOS诊断标准,PCOS患者血清AMH水平升高,且与女性激素失衡和卵泡发育异常相关。

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