Reinehr Thomas, Kulle Alexandra, Rothermel Juliane, Knop Caroline, Lass Nina, Bosse Christina, Holterhus Paul-Martin
Department of Pediatric Endocrinology, Diabetes, and Nutrition Medicine, Vestische Hospital for Children and Adolescents, University of Witten/Herdecke, Datteln, Germany.
Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, University Hospital of Schleswig-Holstein, UKSH, Campus Kiel/Christian Albrechts University of Kiel, CAU, Kiel, Germany.
Clin Endocrinol (Oxf). 2017 Aug;87(2):185-193. doi: 10.1111/cen.13358. Epub 2017 May 29.
The Anti-Muellerian Hormone (AMH) has been reported as surrogate marker of antral follicles, which are the origins of hyperandrogenism in polycystic ovarian syndrome (PCOS). Therefore, AMH may be useful for the diagnosis of PCOS. The objective was to study the longitudinal changes in AMH concentrations in girls with and without PCOS.
This is a longitudinal study of obese girls participating in a 1-year lifestyle intervention.
Forty obese girls aged 13-16 years (50% with PCOS) were included in the study. Girls with and without PCOS were matched to age, BMI and change in weight status.
AMH, gonadotropins, androstenedione, testosterone, oestradiol and sex hormone-binding globulin (SHBG) were determined.
Obese girls with PCOS demonstrated significantly (P<.001) higher AMH concentrations (5.8±3.1 ng/mL) compared to obese girls without PCOS (2.4±1.4 ng/mL). None of the girls without PCOS had AMH concentrations ≥6 ng/mL and none of the PCOS girls showed AMH concentrations ≤3 ng/mL. Weight loss in girls with PCOS was associated with a significant drop in AMH concentrations (-1.4±1.8 ng/mL, P=.045). AMH was significantly related to testosterone (cross-sectional: b-coefficient 3.7±1.7, P=.001, longitudinal: b-coefficient 0.54±0.47, P=.026) and luteinizing hormone (LH) (cross-sectional: b-coefficient 0.05±0.04, P=.039, longitudinal: b-coefficient 0.005±0.004, P=.039), but not to any other analysed parameter in multiple linear regression analyses adjusted to multiple confounders.
AMH was increased in adolescent girls with PCOS and normalized with weight loss. AMH was cross-sectionally and longitudinally related to hyperandrogenism.
抗苗勒管激素（AMH）已被报道为窦卵泡的替代标志物，而窦卵泡是多囊卵巢综合征（PCOS）中高雄激素血症的起源。因此，AMH可能有助于PCOS的诊断。本研究旨在探讨患有和未患有PCOS的女孩AMH浓度的纵向变化。
这是一项对参与为期1年生活方式干预的肥胖女孩进行的纵向研究。
40名年龄在13 - 16岁的肥胖女孩（其中50%患有PCOS）被纳入研究。患有和未患有PCOS的女孩在年龄、体重指数和体重状况变化方面进行了匹配。
测定AMH、促性腺激素、雄烯二酮、睾酮、雌二醇和性激素结合球蛋白（SHBG）。
与未患PCOS的肥胖女孩（2.4±1.4 ng/mL）相比，患PCOS的肥胖女孩AMH浓度显著更高（5.8±3.1 ng/mL，P<0.001）。未患PCOS的女孩中没有AMH浓度≥6 ng/mL的，患PCOS的女孩中也没有AMH浓度≤3 ng/mL的。患PCOS女孩体重减轻与AMH浓度显著下降相关（-1.4±1.8 ng/mL，P = 0.045）。在调整多个混杂因素的多元线性回归分析中，AMH与睾酮显著相关（横断面：b系数3.7±1.7，P = 0.001；纵向：b系数0.54±0.47，P = 0.026）以及与促黄体生成素（LH）显著相关（横断面：b系数0.05±0.04，P = 0.039；纵向：b系数0.005±0.004，P = 0.039），但与其他任何分析参数均无显著相关性。
患有PCOS的青春期女孩AMH升高，体重减轻后恢复正常。AMH在横断面和纵向上均与高雄激素血症相关。
