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激素谱分析,包括抗苗勒管激素(AMH),用于多囊卵巢综合征(PCOS)的诊断和 PCOS 表型的特征描述。

Hormone profiling, including anti-Müllerian hormone (AMH), for the diagnosis of polycystic ovary syndrome (PCOS) and characterization of PCOS phenotypes.

机构信息

a Department of Obstetrics and Gynaecology , University of Oulu and Oulu University Hospital, Medical Research Centre, PEDEGO Research Unit , Oulu , Finland.

b Department of Obstetrics and Gynaecology , University of Helsinki and Helsinki University Hospital , Helsinki , Finland.

出版信息

Gynecol Endocrinol. 2019 Jul;35(7):595-600. doi: 10.1080/09513590.2018.1559807. Epub 2019 Jan 22.

Abstract

Objective was to evaluate serum anti-Müllerian hormone (AMH) levels in polycystic ovary syndrome (PCOS) and in its different phenotypes in relation to clinical, endocrine and metabolic parameters using a new automated VIDAS method and to compare it with the Gen II method. Study design was multi-center study including 319 PCOS women and 109 healthy controls. Serum AMH levels measured using VIDAS were significantly higher in PCOS women than controls ( < .001), and they correlated with those measured using the AMH Gen II method. An AMH cutoff value of 42.1 pmol/L distinguished PCOS women from controls with 67% sensitivity and 83% specificity. The PCOS women with three Rotterdam criteria or hyperandrogenism displayed significantly higher AMH levels compared with those with two Rotterdam criteria or normoandrogenism. In PCOS, AMH levels correlated positively with luteinizing hormone (LH), androgen and sex hormone-binding globulin (SHBG) levels and negatively with BMI, abdominal obesity, follicle-stimulating hormone (FSH), fasting glucose and insulin, and insulin resistance. In conclusion, AMH evaluated using the VIDAS method distinguished PCOS patients from healthy controls relatively well, especially in those with more severe phenotypes. Further studies are needed to establish whether AMH measurements can distinguish PCOS patients with different metabolic risk factors.

摘要

目的是使用新的自动化 VIDAS 方法评估多囊卵巢综合征 (PCOS) 患者及其不同表型的血清抗苗勒管激素 (AMH) 水平与临床、内分泌和代谢参数的关系,并与第二代 AMH 方法进行比较。研究设计为多中心研究,纳入 319 名 PCOS 患者和 109 名健康对照者。使用 VIDAS 测量的血清 AMH 水平在 PCOS 患者中显著高于对照组( < 0.001),并与第二代 AMH 方法测量的结果相关。AMH 截断值为 42.1 pmol/L 时,以 67%的敏感性和 83%的特异性区分 PCOS 患者和对照组。与具有两个 Rotterdam 标准或正常雄激素血症的患者相比,具有三个 Rotterdam 标准或高雄激素血症的 PCOS 患者的 AMH 水平显著更高。在 PCOS 中,AMH 水平与黄体生成素 (LH)、雄激素和性激素结合球蛋白 (SHBG) 水平呈正相关,与 BMI、腹型肥胖、卵泡刺激素 (FSH)、空腹血糖和胰岛素以及胰岛素抵抗呈负相关。结论:使用 VIDAS 方法评估的 AMH 能较好地区分 PCOS 患者和健康对照者,尤其在表型更为严重的患者中。需要进一步的研究来确定 AMH 测量是否可以区分具有不同代谢危险因素的 PCOS 患者。

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