Kim Joon Young, Tfayli Hala, Michaliszyn Sara F, Lee SoJung, Nasr Alexis, Arslanian Silva
Division of Weight Management and Wellness, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
J Adolesc Health. 2017 Mar;60(3):333-339. doi: 10.1016/j.jadohealth.2016.10.015. Epub 2016 Dec 18.
Anti-Müllerian hormone (AMH) is proposed as a biomarker of polycystic ovary syndrome (PCOS). This study investigated: (1) AMH concentrations in obese adolescents with PCOS versus without PCOS; (2) the relationship of AMH to sex steroid hormones, adiposity, and insulin resistance; and (3) the optimal AMH value and the multivariable prediction model to determine PCOS in obese adolescents.
AMH levels were measured in 46 obese PCOS girls and 43 obese non-PCOS girls. Sex steroid hormones, clamp-measured insulin sensitivity and secretion, body composition, and abdominal adiposity were evaluated. Logistic regression and receiver-operating characteristic curve analyses were used, and multivariate prediction models were developed to test the utility of AMH for the diagnosis of PCOS.
AMH levels were higher in obese PCOS versus non-PCOS girls (8.3 ± .6 vs. 4.3 ± .4 ng/mL, p < .0001), of comparable age and puberty. AMH concentrations correlated positively with age in both groups, total and free testosterone in PCOS girls only, abdominal adipose tissue in non-PCOS girls, with no correlation to in vivo insulin sensitivity and secretion in either groups. A multivariate model including AMH (cutoff 6.26 ng/mL, area under the curve .788) together with sex hormone-binding globulin and total testosterone exhibited 93.4% predictive power for diagnosing PCOS.
AMH may be a useful biomarker for the diagnosis of PCOS in obese adolescent girls.
抗苗勒管激素（AMH）被提议作为多囊卵巢综合征（PCOS）的生物标志物。本研究调查了：（1）患有PCOS的肥胖青少年与未患PCOS的肥胖青少年的AMH浓度；（2）AMH与性类固醇激素、肥胖和胰岛素抵抗的关系；（3）用于确定肥胖青少年是否患有PCOS的最佳AMH值和多变量预测模型。
对46名肥胖的PCOS女孩和43名肥胖的非PCOS女孩测量了AMH水平。评估了性类固醇激素、钳夹测量的胰岛素敏感性和分泌、身体成分以及腹部肥胖情况。使用了逻辑回归和受试者工作特征曲线分析，并建立了多变量预测模型来测试AMH在诊断PCOS中的效用。
在年龄和青春期相当的情况下，肥胖的PCOS女孩的AMH水平高于非PCOS女孩（8.3±0.6 vs. 4.3±0.4 ng/mL，p<0.0001）。两组中AMH浓度均与年龄呈正相关，仅在PCOS女孩中与总睾酮和游离睾酮呈正相关，在非PCOS女孩中与腹部脂肪组织呈正相关，在两组中均与体内胰岛素敏感性和分泌无关。一个包括AMH（临界值6.26 ng/mL，曲线下面积0.788）以及性激素结合球蛋白和总睾酮的多变量模型对诊断PCOS具有93.4%的预测能力。
AMH可能是诊断肥胖青春期女孩PCOS的有用生物标志物。
