Université de Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille F-59000, France; AP-HP- Université Sorbonne Paris-Nord, Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Jean Verdier, Bondy F-93143, France; CHU Lille, Service de Gynécologie Médicale, Hôpital Jeanne de Flandre, Lille F-59000, France.
Université de Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille F-59000, France; CHU Lille, Service de Biochimie et Hormonologie, Centre de Biologie Pathologie, Lille F-59000, France.
Reprod Biomed Online. 2020 Dec;41(6):1112-1121. doi: 10.1016/j.rbmo.2020.07.020. Epub 2020 Jul 25.
Does the relative distribution of anti-Müllerian hormone (AMH) isoforms differ between patients depending on their body mass index (BMI) and polycystic ovary syndrome (PCOS) status in serum and follicular fluid?
Obese and normal weight patients (PCOS [n = 70]; non-PCOS [n = 37]) were selected for this case-control study in the serum. Between 2018 and 2019, obese (n = 19) and normal weight (n = 20) women with or without PCOS who were receiving IVF treatment were included in the follicular fluid study. The bio-banked serums and follicular fluid were tested for total AMH (proAMH and AMH combined) and proAMH using an automatic analyzer. The AMH prohormone index (API = [proAMH]/[total AMH]x 100) was calculated as an inverse marker of conversion of proAMH to AMH, with only the latter isoform that could bind to the AMH receptor complex.
The API was not significantly different between controls and women with PCOS, whereas obese women had a lower API compared with their normal weight counterparts. Grouping PCOS and controls, a lower API was found in obese versus normal weight women, suggesting a greater conversion of proAMH to AMH. The API in the serum was significantly correlated with metabolic parameters. In the follicular fluid, API is not different between obese and normal weight women independently of PCOS and is higher than in the concomitant serum.
The proportion of inactive form of AMH in the serum is higher in normal weight versus obese women but not in the follicular fluid, independently of PCOS. The conversion of proAMH into the cleaved isoform is likely to occur in extra-ovarian tissues and to exacerbate in obese individuals.
血清和卵泡液中，抗苗勒管激素（AMH）同工型的相对分布是否因患者的体重指数（BMI）和多囊卵巢综合征（PCOS）状态而异？
本病例对照研究选择了肥胖和正常体重患者（PCOS [n=70]；非 PCOS [n=37]）进行血清研究。在 2018 年至 2019 年间，纳入了接受体外受精治疗的肥胖（n=19）和正常体重（n=20）的 PCOS 和非 PCOS 妇女，对其卵泡液进行了研究。使用自动分析仪对生物样本库血清和卵泡液进行总 AMH（proAMH 和 AMH 组合）和 proAMH 的检测。AMH 前激素指数（API=[proAMH]/[总 AMH]x100）被计算为 proAMH 转化为 AMH 的逆标记物，只有后者同工型才能与 AMH 受体复合物结合。
API 在对照组和 PCOS 患者之间无显著差异，而肥胖妇女的 API 低于正常体重妇女。将 PCOS 和对照组分组后，肥胖妇女的 API 低于正常体重妇女，提示 proAMH 向 AMH 的转化增加。血清中的 API 与代谢参数显著相关。在卵泡液中，API 与肥胖或正常体重妇女的 PCOS 无关，且高于相应的血清。
血清中 AMH 无活性形式的比例在正常体重妇女中高于肥胖妇女，但在卵泡液中则不然，与 PCOS 无关。proAMH 转化为裂解同工型可能发生在卵巢外组织中，并在肥胖个体中加重。
