Tokmak Aytekin, Timur Hakan, Aksoy Rıfat Taner, Çınar Mehmet, Yılmaz Nafiye
Zekai Tahir Burak Women's Health Education and Research Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey.
Turk J Obstet Gynecol. 2015 Dec;12(4):199-204. doi: 10.4274/tjod.21549. Epub 2015 Dec 15.
To evaluate serum anti-Mullerian hormone (AMH) levels in adolescent and young adult (AYA) Turkish patients with Polycystic ovary syndrome (PCOS), and to determine whether it had a diagnostic value.
A total of 90 AYA patients were recruited for this study. The study group consisted of 43 patients diagnosed as having PCOS, and the control group comprised 47 age-matched patients. The diagnosis of PCOS was made in accordance with the recent Amsterdam European Society of Human Reproduction and Embryology/American Society for Reproductive Medicine PCOS consensus workshop group's proposal that all three of the Rotterdam criteria for diagnosing PCOS in adolescents be present. In all patients, serum AMH levels were measured using enzyme-linked immunosorbent assay. Receiver operator characteristics (ROC) curve analysis was performed to reveal diagnostic potential of AMH.
Serum AMH levels were higher in the PCOS group compared with controls, but the difference was not statistically significant (10.1±6.9 ng/mL vs. 9.4±5.5 ng/mL, p=0.198). There was a significant age-related decrease in AMH levels in both the study and control groups (r=-0.331, p=0.001). There was also a significant inverse correlation between serum AMH and follicle-stimulating hormone levels in all patients (r=-0.227, p=0.031). ROC analyses demonstrated that the area under the curve indicative of AMH value for discriminating PCOS was 0.579 with a 95% confidence interval of 0.453-0.705 (p=0.198). The cut-off value according to the highest Youden index was calculated to be 14.0 ng/mL with a sensitivity of 48.8% and specificity of 77.1%.
Serum AMH levels are slightly higher in AYA patients with PCOS than in controls. However, AMH is not a good marker for the diagnosis of PCOS in AYA patients.
评估患有多囊卵巢综合征（PCOS）的土耳其青少年及青年（AYA）患者的血清抗苗勒管激素（AMH）水平，并确定其是否具有诊断价值。
本研究共纳入90例AYA患者。研究组由43例诊断为PCOS的患者组成，对照组包括47例年龄匹配的患者。PCOS的诊断依据最近阿姆斯特丹欧洲人类生殖与胚胎学会/美国生殖医学学会PCOS共识研讨会小组的提议，即青少年PCOS诊断的所有三项鹿特丹标准均需满足。对所有患者采用酶联免疫吸附测定法检测血清AMH水平。进行受试者操作特征（ROC）曲线分析以揭示AMH的诊断潜力。
PCOS组血清AMH水平高于对照组，但差异无统计学意义（10.1±6.9 ng/mL对9.4±5.5 ng/mL，p = 0.198）。研究组和对照组的AMH水平均随年龄显著下降（r = -0.331，p = 0.001）。所有患者血清AMH与促卵泡生成素水平之间也存在显著负相关（r = -0.227，p = 0.031）。ROC分析表明，用于区分PCOS的AMH值曲线下面积为0.579，95%置信区间为0.453 - 0.705（p = 0.198）。根据最高约登指数计算的截断值为14.0 ng/mL，敏感性为48.8%，特异性为77.1%。
患有PCOS的AYA患者血清AMH水平略高于对照组。然而，AMH并非AYA患者PCOS诊断的良好标志物。
