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多囊卵巢综合征年轻女性的抗苗勒管激素水平与心脏代谢风险。

Antimüllerian hormone levels and cardiometabolic risk in young women with polycystic ovary syndrome.

机构信息

Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania.

Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania.

出版信息

Fertil Steril. 2017 Jan;107(1):276-281. doi: 10.1016/j.fertnstert.2016.10.009. Epub 2016 Nov 11.

Abstract

OBJECTIVE

To determine the association between antimüllerian hormone (AMH) levels and metabolic syndrome (MetSyn) in young women with polycystic ovary syndrome (PCOS).

DESIGN

Cross-sectional study.

SETTING

Academic PCOS center.

PATIENT(S): A total of 252 women aged 18-46 years with PCOS.

INTERVENTION

None.

MAIN OUTCOME MEASURE(S): Association of AMH with markers of cardiometabolic risk and MetSyn.

RESULT(S): The median AMH level was 5.1 ng/mL (interquartile range [IQR] 3.0-8.1), and prevalence of MetSyn was 23.8%. AMH levels positively correlated with total T, high-density lipoprotein (HDL) cholesterol, and SHBG and negatively correlated with fasting glucose, homeostasis-model assessment of insulin resistance, body mass index (BMI), and systolic and diastolic blood pressure. A single-unit decrease in AMH was associated with an 11% increase in odds of MetSyn (odds ratio [OR] 1.11, 95% confidence interval [CI] 1.03-1.20); the strength of this association was maintained in the multivariate model (OR 1.09, 95% CI 1.01-1.18) adjusting for age and race. Subjects with AMH values in the lowest tertile were twice as likely as those in the highest tertile to have MetSyn (adjusted OR 2.1, 95% CI 1.01-4.3). Total T was not associated with MetSyn or its individual components.

CONCLUSION(S): Our findings indicate that in young women with PCOS, low AMH levels predict a greater risk of MetSyn. The role of AMH, an established biomarker of ovarian reserve, in risk stratification of cardiometabolic risk in obese women with PCOS needs to be clarified in longitudinal studies and in the perimenopausal population.

摘要

目的

确定抗缪勒管激素(AMH)水平与多囊卵巢综合征(PCOS)年轻女性代谢综合征(MetSyn)之间的关系。

设计

横断面研究。

地点

学术 PCOS 中心。

患者

共 252 名年龄在 18-46 岁的 PCOS 女性。

干预

无。

主要观察指标

AMH 与心血管代谢风险和 MetSyn 标志物的相关性。

结果

AMH 中位数为 5.1ng/ml(四分位距[IQR]3.0-8.1),MetSyn 的患病率为 23.8%。AMH 水平与总睾酮、高密度脂蛋白(HDL)胆固醇和性激素结合球蛋白呈正相关,与空腹血糖、胰岛素抵抗稳态模型评估、体重指数(BMI)和收缩压及舒张压呈负相关。AMH 降低一个单位,MetSyn 的几率增加 11%(比值比[OR]1.11,95%置信区间[CI]1.03-1.20);在调整年龄和种族的多变量模型中,这种相关性仍然存在(OR 1.09,95%CI 1.01-1.18)。AMH 值处于最低三分位数的受试者发生 MetSyn 的可能性是最高三分位数的受试者的两倍(调整后的 OR 2.1,95%CI 1.01-4.3)。总睾酮与 MetSyn 或其单个成分均无关。

结论

我们的研究结果表明,在年轻的 PCOS 女性中,低 AMH 水平预示着 MetSyn 的风险增加。在肥胖的 PCOS 女性中,AMH 作为卵巢储备的既定生物标志物,在心血管代谢风险的分层中的作用,需要在纵向研究和围绝经期人群中加以阐明。

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