Asanidze E, Khristesashvili J, Pkhaladze L, Barbakadze L
I. Javakhishvili Tbilisi State University, Faculty of Medicine; Center for Reproductive Medicine "Universe"; Archil Khomasuridze Institute of Reproductology, Tbilisi ,Georgia.
Georgian Med News. 2018 Feb(Issue):34-40.
PCOS has a leading place in women's infertility. Based on the data of recent researches, Anti-Mullerian hormone (AMH) has been considered as one of the diagnostic criteria for PCOS. The aim of study was to determine the correlation of Anti-Mullerian hormone with hormonal and ovarian morphological characteristics in patients with PCOS, with and without insulin resistance. 110 women with diagnosis of PCOS were involved in the study. Patients were divided into two groups: PCOS patients with insulin resistance (60 women) and PCOS patients without insulin resistance (50 women). All patients underwent hormonal investigation (AMH, FSH, LH, T, FT, HOMA- IR, FAI and SHBG). The volume of ovaries and the number of antral follicles (AFC) were determined by ultrasound imaging. Сorrelation between AMH and the ovarian hormonal and morphological characteristics has been shown. In particular, a significant positive correlation between AMH and the volume of the ovaries in both groups was demonstrated. In the group of patients with PCOS and insulin resistance a positive correlation between AMH and the volum of ovary, AFC was shown, as well as a negative correlation between AMH and SHBG. In the same group a tendency of the positive correlation between AMH and TT, HOMA-IR and IRI was seen. In the group of patients with PCOS without insulin resistence a positive correlation between AMH and the volum of ovary was observed, as well as the tendency of positive correlation between AMH and AFC, TT, HOMA-IR, IRI. Additionally, a negative correlation between AMH and SHBG was seen in the later patient group. Increased levels of AMH in all PCOS patients in our study, in comparison with the accepted norm, indicates on possibility of using this data in the diagnosis of PCOS. AMH levels in PCOS patients with and without insulin resistance do not differ significantly. The correlation between AMH and the morphological characteristics of ovaries has been established.
多囊卵巢综合征（PCOS）在女性不孕症中占据首要位置。基于近期研究数据，抗苗勒管激素（AMH）已被视为PCOS的诊断标准之一。本研究的目的是确定PCOS患者中，无论有无胰岛素抵抗，抗苗勒管激素与激素及卵巢形态特征之间的相关性。110例诊断为PCOS的女性参与了本研究。患者被分为两组：有胰岛素抵抗的PCOS患者（60例女性）和无胰岛素抵抗的PCOS患者（50例女性）。所有患者均接受了激素检查（AMH、促卵泡生成素、促黄体生成素、睾酮、游离睾酮、胰岛素抵抗指数、游离雄激素指数和性激素结合球蛋白）。通过超声成像确定卵巢体积和窦卵泡数量（AFC）。已显示出AMH与卵巢激素及形态特征之间的相关性。特别是，两组中AMH与卵巢体积之间均显示出显著正相关。在有胰岛素抵抗的PCOS患者组中，AMH与卵巢体积、AFC之间呈正相关，且AMH与性激素结合球蛋白之间呈负相关。在同一组中，AMH与总睾酮、胰岛素抵抗指数和胰岛素抵抗指数之间存在正相关趋势。在无胰岛素抵抗的PCOS患者组中，观察到AMH与卵巢体积之间呈正相关，以及AMH与AFC、总睾酮、胰岛素抵抗指数、胰岛素抵抗指数之间存在正相关趋势。此外，后一组患者中AMH与性激素结合球蛋白之间呈负相关。与公认的正常水平相比，我们研究中所有PCOS患者的AMH水平升高表明了利用这些数据诊断PCOS的可能性。有和无胰岛素抵抗的PCOS患者的AMH水平无显著差异。已建立了AMH与卵巢形态特征之间的相关性。
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