Calzada Mireya, López Natividad, Noguera Jose A, Mendiola Jaime, Hernández Ana I, Corbalán Shiana, Sanchez Maria, Torres Alberto M
Clinical Analysis Service, Hospital University "Virgen de la Arrixaca" , Murcia , Spain.
Department of Health and Social Sciences, Division of Preventive Medicine and Public Health, University of Murcia , Murcia , Spain.
J Obstet Gynaecol. 2019 Nov;39(8):1130-1136. doi: 10.1080/01443615.2019.1587604. Epub 2019 Jun 17.
Serum Anti-Müllerian hormone (AMH) level could be useful for the diagnosis of polycystic ovary syndrome (PCOS). We evaluated the hormonal status in women for the diagnosis of PCOS. A total of 77 PCOS women and 106 healthy women were enrolled in this study. Serum AMH, gonadotropins [luteinising hormone (LH) and follicle-stimulating hormone (FSH)], oestradiol, testosterone (total and free), 4-androstenedione (ANDST), dehydroepiandrosterone sulphate, sex hormone binding globulin (SHBG), prolactin, thyroid-stimulating hormone and insulin levels were measured in all enrolled women. Our data showed that insulin LH, testosterone, ANDST and AHM levels were significantly higher in the PCOS group and FSH and SHBG levels were lower in the PCOS group. In Receiver operating characteristic analysis, the combination of AMH with SHBG showed higher area under curves (AUC) for PCOS diagnosis with an AUC of 0.843 and a specificity of 81.1% and a sensitivity of 72.7%. Our results suggest that a combination of serum AMH and SHBG levels could be used as a diagnostic biomarker of PCOS. Impact statement Women with PCOS have an increased risk of hypertension, altered glucose metabolism and probably an increased lifetime risk of cardiovascular diseases. There is no consensus on the diagnostic criteria for PCOS. This leads to many patients with PCOS are being undiagnosed. It is known that AMH plays a role in the follicular status of PCOS and serum AMH level is increased significantly in women with PCOS compared with normo-ovulatory women. This is why several studies have suggested the inclusion of AMH as a diagnostic criterion in PCOS. Extensive epidemiological data is available which demonstrates an association between higher AMH levels and PCOS, but there was no information available about the combination of AMH level with other hormones and PCOS. This is the first study that has investigated the association of AMH and SHBG, together, with PCOS. Our results suggest that serum AMH and SHBG level in combination could represent a useful and practical test to screen the general population for PCOS. Many PCOS women in the general population are undiagnosed due to lack of consensus in diagnostic criteria. Therefore, the importance of identifying women with PCOS due to the need for follow-up in short and long-term health risk.
血清抗苗勒管激素（AMH）水平可能有助于多囊卵巢综合征（PCOS）的诊断。我们评估了女性的激素状态以用于PCOS的诊断。本研究共纳入了77例PCOS女性和106例健康女性。检测了所有纳入女性的血清AMH、促性腺激素[黄体生成素（LH）和卵泡刺激素（FSH）]、雌二醇、睾酮（总睾酮和游离睾酮）(4 -)雄烯二酮（ANDST）、硫酸脱氢表雄酮、性激素结合球蛋白（SHBG）、催乳素、促甲状腺激素和胰岛素水平。我们的数据显示，PCOS组的胰岛素、LH、睾酮、ANDST和AHM水平显著更高，而PCOS组的FSH和SHBG水平更低。在受试者工作特征分析中，AMH与SHBG联合用于PCOS诊断时曲线下面积（AUC）更高，AUC为0.843，特异性为81.1%，敏感性为72.7%。我们的结果表明，血清AMH和SHBG水平联合可作为PCOS的诊断生物标志物。影响声明：PCOS女性患高血压、糖代谢改变的风险增加，心血管疾病终身风险可能也会增加。关于PCOS的诊断标准尚无共识。这导致许多PCOS患者未被诊断。已知AMH在PCOS的卵泡状态中起作用，与正常排卵女性相比，PCOS女性的血清AMH水平显著升高。这就是为什么几项研究建议将AMH纳入PCOS的诊断标准。有大量流行病学数据表明AMH水平升高与PCOS之间存在关联，但关于AMH水平与其他激素联合和PCOS的信息尚无。这是第一项研究AMH和SHBG联合与PCOS之间关联的研究。我们的结果表明，血清AMH和SHBG水平联合可能是一种用于筛查普通人群中PCOS的有用且实用的检测方法。由于诊断标准缺乏共识，普通人群中有许多PCOS女性未被诊断。因此，由于需要对短期和长期健康风险进行随访，识别PCOS女性非常重要。
