Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Obstetrics and Gynecology, Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Endocrinol (Lausanne). 2021 Apr 14;12:626534. doi: 10.3389/fendo.2021.626534. eCollection 2021.
The reference range and potential value of inhibin B are still unclear and controversial. This study aimed to define the variation trend of inhibin B in healthy women with age and explore its value in the reflection of ovarian reserve.
A total of 2524 healthy reproductive age women from eight medical institutes nationwide were recruited. The variation tendency of inhibin B with age was primarily established in the first group of 948 women and validated in another 605. We evaluated the relationship between inhibin B and classic ovarian reserve and function markers. The potency of inhibin B in predicting AFC <5-7 was also estimated and compared with FSH.
The nomogram showed that serum levels of inhibin B rapidly decreased after the age of 40. Inhibin B was positively correlated with AMH (R = 0.57, P < 0.001), AFC (R = 0.34, P < 0.001) and testosterone (R = 0.10, P = 0.002), and negatively correlated with FSH (R = -0.41, P < 0.001) and LH (R = -0.20, P < 0.001) and FSH/LH (R=-0.18, P < 0.001), while no correlation was found with PRL. Unexpectedly, Inhibin B (AUC = 0.74, P < 0.001 for the establishment population; AUC = 0.78, P < 0.001 for the validation population) had a slightly higher value than FSH (AUC = 0.71, P < 0.001 for the establishment population; AUC = 0.72, P < 0.001 for the validation population) in diagnosing AFC <5-7.
For healthy reproductive age women, the decline of inhibin B can reflect decreased ovarian reserve effectively, having a good consistency with AMH and AFC. More importantly, inhibin B had an advantage in predicting AFC <5-7 compared with FSH, which suggested the potential of inhibin B in predicting ovarian response. These results will be helpful to the clinical application of inhibin B in the evaluation of female ovarian reserve and the assessment of their reproductive capacity. Trial registration: http://clinicaltrials.gov; NCT02294500.
抑制素 B 的参考范围和潜在价值仍不明确且存在争议。本研究旨在确定健康育龄妇女随年龄变化的抑制素 B 变化趋势，并探讨其在反映卵巢储备功能方面的价值。
本研究共纳入全国 8 家医学研究所的 2524 名健康育龄期女性。首先在第 1 组 948 名女性中建立抑制素 B 随年龄变化的趋势，然后在另 605 名女性中验证。我们评估了抑制素 B 与经典卵巢储备和功能标志物之间的关系。还评估了抑制素 B 在预测 AFC<5-7 方面的作用，并与 FSH 进行了比较。
列线图显示，血清抑制素 B 水平在 40 岁后迅速下降。抑制素 B 与 AMH（R=0.57，P<0.001）、AFC（R=0.34，P<0.001）和睾酮（R=0.10，P=0.002）呈正相关，与 FSH（R=-0.41，P<0.001）、LH（R=-0.20，P<0.001）和 FSH/LH（R=-0.18，P<0.001）呈负相关，与 PRL 无相关性。出乎意料的是，抑制素 B（AUC=0.74，P<0.001，建立人群；AUC=0.78，P<0.001，验证人群）在诊断 AFC<5-7 方面的价值略高于 FSH（AUC=0.71，P<0.001，建立人群；AUC=0.72，P<0.001，验证人群）。
对于健康的育龄期女性，抑制素 B 的下降可以有效反映卵巢储备功能的降低，与 AMH 和 AFC 具有很好的一致性。更重要的是，抑制素 B 在预测 AFC<5-7 方面优于 FSH，这表明抑制素 B 在预测卵巢反应方面具有一定潜力。这些结果将有助于抑制素 B 在评估女性卵巢储备和生育能力方面的临床应用。试验注册：http://clinicaltrials.gov；NCT02294500。
