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多囊卵巢综合征女性绝经年龄的预测

Prediction of age at menopause in women with polycystic ovary syndrome.

作者信息

Minooee S, Ramezani Tehrani F, Rahmati M, Mansournia M Ali, Azizi F

机构信息

a Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences , Shahid Beheshti University of Medical Sciences , Tehran , I.R. Iran.

b Department of Epidemiology and Biostatistics, School of Public Health , Tehran University of Medical Sciences , Tehran , I.R. Iran.

出版信息

Climacteric. 2018 Feb;21(1):29-34. doi: 10.1080/13697137.2017.1392501. Epub 2017 Nov 6.

Abstract

OBJECTIVE

Considering the role of anti-Müllerian hormone (AMH) in female fertility and its high levels in women with polycystic ovary syndrome (PCOS), the longer reproductive span of these women is in doubt. In the present study, we aimed to improve earlier predictions using a non-linear model to substantiate the question as to whether PCOS women reach menopause later.

METHODS

In total, 1162 women aged 20-50 years, comprising 378 PCOS cases and 784 eumenorrheic non-hirsute women, met the eligibility criteria. A scatterplot matrix was drawn to detect the association between age and AMH; this association was explored using a fractional polynomial regression model. Model assumptions were checked by examining the distribution of the residuals and plotting the standardized residuals against the functional form of AMH.

RESULTS

The serum concentration of AMH among PCOS participants was significantly higher than in the controls (5.4 ng/ml (IQR 2.8-9.1 ng/ml) vs. 1.4 ng/ml (IQR 0.6-2.7 ng/ml), p < 0.001). The estimated mean age at menopause was 51.4 (95% CI 45-59) years and 49.7 (95% CI 45-55) years in PCOS cases and healthy controls, respectively.

CONCLUSIONS

These findings provide the insight that, as reflected through significantly higher average levels of AMH in PCOS women, their predicted reproductive lifespan could be 2 years longer than their normo-ovulatory counterparts.

摘要

目的

鉴于抗苗勒管激素(AMH)在女性生育中的作用以及多囊卵巢综合征(PCOS)女性体内AMH水平较高,这些女性的生育期延长这一说法存疑。在本研究中,我们旨在使用非线性模型改进早期预测,以证实PCOS女性绝经时间是否更晚这一问题。

方法

共有1162名年龄在20至50岁之间的女性符合纳入标准,其中包括378例PCOS患者和784例月经正常且无多毛症的女性。绘制散点图矩阵以检测年龄与AMH之间的关联;使用分数多项式回归模型探索这种关联。通过检查残差分布并将标准化残差与AMH的函数形式作图来检验模型假设。

结果

PCOS参与者的血清AMH浓度显著高于对照组(5.4 ng/ml(四分位间距2.8 - 9.1 ng/ml) vs. 1.4 ng/ml(四分位间距0.6 - 2.7 ng/ml),p < 0.001)。PCOS患者和健康对照组的绝经平均年龄估计分别为51.4岁(95%置信区间45 - 59岁)和49.7岁(95%置信区间45 - 55岁)。

结论

这些发现表明,正如PCOS女性中显著更高的AMH平均水平所反映的那样,她们预测的生育寿命可能比排卵正常的女性长2年。

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