Division of Endocrinology Department of Pediatrics, Medical School, University of Patras, Patra, Greece.
Division of Endocrinology Department of Pediatrics, Medical School, University of Patras, Patra, Greece.
J Pediatr. 2019 Feb;205:190-194. doi: 10.1016/j.jpeds.2018.09.064. Epub 2018 Oct 24.
To assess whether the serum levels of anti-Müllerian hormone (AMH) are increased in girls with premature adrenarche because they are at a higher risk of developing polycystic ovary syndrome (PCOS) later in life.
We measured serum levels of AMH, dehydroepiandrosterone sulfate (DHEAS), testosterone, sex hormone binding globulin, androstenedione, and 17-hyroxyprogesterone in 89 girls with premature adrenarche aged 6.98 ± 1.60 years, and in 55 prepubertal normal girls aged 6.78 ± 1.60 years.
AMH was significantly higher in girls with premature adrenarche (2.95 ± 1.20 ng/mL) compared with normal prepubertal girls (2.00 ± 0.95 ng/mL; P < .001), whereas their body mass index SD score was similar (P > .05). DHEAS, testosterone, and androstenedione were increased in premature adrenarche, whereas sex hormone binding globulin was decreased in girls with premature adrenarche. Among the 89 girls with premature adrenarche, 33 were daughters of mothers with a positive history of PCOS, whereas the mothers of the remaining 56 girls with premature adrenarche had a negative history of PCOS. The girls with a mother with a positive history of PCOS had significantly higher AMH serum levels compared with girls with a mother with a negative history of PCOS (3.37 ± 1.72 ng/mL vs 2.70 ± 1.25 ng/mL; P < .05) with no differences in testosterone, DHEAS, androstenedione, and sex hormone binding globulin. The serum concentration of AMH was only positively related to androstenedione (r = 0.538; P < .0001).
Girls with premature adrenarche, especially those from mothers with a history of PCOS, could have a higher risk of developing PCOS later in life because they have increased serum AMH.
评估患有早熟性肾上腺功能初现的女孩血清抗苗勒管激素（AMH）水平是否升高，因为她们以后发生多囊卵巢综合征（PCOS）的风险更高。
我们测量了 89 例年龄为 6.98±1.60 岁的早熟性肾上腺功能初现女孩和 55 例年龄为 6.78±1.60 岁的青春期前正常女孩的血清 AMH、脱氢表雄酮硫酸盐（DHEAS）、睾酮、性激素结合球蛋白、雄烯二酮和 17-羟孕酮水平。
与青春期前正常女孩（2.00±0.95ng/mL）相比，早熟性肾上腺功能初现女孩的 AMH 水平显著升高（2.95±1.20ng/mL；P<0.001），但其体重指数标准差相似（P>0.05）。DHEAS、睾酮和雄烯二酮在早熟性肾上腺功能初现中升高，而性激素结合球蛋白在早熟性肾上腺功能初现女孩中降低。在 89 例早熟性肾上腺功能初现女孩中，33 例女孩的母亲有 PCOS 阳性病史，而其余 56 例女孩的母亲有 PCOS 阴性病史。母亲有 PCOS 阳性病史的女孩 AMH 血清水平明显高于母亲有 PCOS 阴性病史的女孩（3.37±1.72ng/mL 比 2.70±1.25ng/mL；P<0.05），但睾酮、DHEAS、雄烯二酮和性激素结合球蛋白无差异。AMH 血清浓度仅与雄烯二酮呈正相关（r=0.538；P<0.0001）。
早熟性肾上腺功能初现的女孩，尤其是来自有 PCOS 病史母亲的女孩，以后发生 PCOS 的风险可能更高，因为她们的血清 AMH 升高。
