Center of Reproductive Medicine, Shengjing Hospital of China Medical University, Shenyang, China.
Front Endocrinol (Lausanne). 2021 Jun 4;12:659717. doi: 10.3389/fendo.2021.659717. eCollection 2021.
Obesity is a state of excess body fat accumulation, and appears to be closely associated with polycystic ovary syndrome (PCOS). Notably, plausible biological pathways through which obesity can regulate anti-Müllerian hormone (AMH) production have been proposed, and women with PCOS characteristically have an increased AMH level. Body fat accumulation can be described by body fat percentage (BFP). However, the relationship between BFP and AMH still remains unclear.
A total of 87 controls and 156 PCOS patients were divided into lean and overweight/obese groups, and the PCOS patients were further divided into hyper-AMH and normal-AMH subgroups. Univariate regression was used to assess the unadjusted relationship between AMH and outcome variables, multivariable regression analysis was performed to test whether and how serum AMH levels were associated with BFP after adjusting for other co-variables. Receiver-operating characteristic (ROC) curve analyses were used to test the utility of BFP for the diagnosis of PCOS.
BFP was higher in PCOS patients compared with controls, regardless of obesity. Serum AMH levels were negatively associated with BFP in the PCOS group (r = -0.371; < 0.001) but not in the control group (r = -0.095; = 0.385). Multivariable logistic regression analysis showed that elevated BFP was associated with a high risk of PCOS (odds ratio, 1.290; 95% confidence interval, 1.084-1.534, = 0.004). Furthermore, the combination of BFP and serum AMH into a multivariate model gave an improved area under the curve (AUC) of 88.5%, with a sensitivity of 72.4% and specificity of 87.4%; the positive and negative predictive values were 91.2% and 63.9%, respectively. One limitation of this study is all the conclusion reported was based on small sample size.
Herein, we described the negative correlation between BFP and serum AMH levels for the first time, and the present results highlight the importance of further investigation into the role of BFP, especially in body fat-related AMH change as it relates to the underlying pathogenesis of PCOS.
肥胖是一种体脂肪过度积累的状态,与多囊卵巢综合征(PCOS)密切相关。值得注意的是,已经提出了肥胖通过合理的生物学途径调节抗苗勒氏管激素(AMH)产生的假设,而 PCOS 患者的 AMH 水平通常升高。体脂肪量可以用体脂肪百分比(BFP)来描述。然而,BFP 与 AMH 之间的关系仍不清楚。
共纳入 87 名对照组和 156 名 PCOS 患者,分为瘦组和超重/肥胖组,PCOS 患者进一步分为高 AMH 组和正常 AMH 组。单变量回归用于评估 AMH 与结局变量之间的未经调整关系,多变量回归分析用于测试血清 AMH 水平在调整其他协变量后与 BFP 的关系。接收者操作特征(ROC)曲线分析用于测试 BFP 对 PCOS 诊断的效用。
与对照组相比,无论肥胖与否,PCOS 患者的 BFP 均较高。PCOS 组血清 AMH 水平与 BFP 呈负相关(r = -0.371;<0.001),而对照组则无相关性(r = -0.095;= 0.385)。多变量逻辑回归分析显示,BFP 升高与 PCOS 的高风险相关(优势比,1.290;95%置信区间,1.084-1.534,= 0.004)。此外,将 BFP 和血清 AMH 纳入多元模型可提高曲线下面积(AUC)至 88.5%,敏感性为 72.4%,特异性为 87.4%;阳性预测值和阴性预测值分别为 91.2%和 63.9%。本研究的一个局限性是所有结论均基于小样本量。
本研究首次描述了 BFP 与血清 AMH 水平之间的负相关,结果强调了进一步研究 BFP 作用的重要性,特别是在与体脂肪相关的 AMH 变化方面,因为这与 PCOS 的潜在发病机制有关。