Department of Laboratory Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China.
Center of Clinical Mass Spectrometry, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China.
Front Endocrinol (Lausanne). 2022 Jun 9;13:881740. doi: 10.3389/fendo.2022.881740. eCollection 2022.
The role of excess androgen in ovarian reserve remains unclear in patients with polycystic ovary syndrome (PCOS). Our study highlights the associations of serum androgen levels and ovarian reserve markers in PCOS and non-PCOS women.
Totally 584 menstrual abnormalities women of 20-45 years were retrospectively evaluated at the Beijing Obstetrics and Gynecology Hospital between January 2021 to October 2021. The enrolled patients were classified into two groups: the PCOS group (n=288) and the non-PCOS group (n=296) based on the Rotterdam consensus for PCOS diagnosis. The serum androgens, including testosterone (T), free testosterone (FT, calculated), bioavailable testosterone (Bio-T, calculated), androstenedione (A2), dihydrotestosterone (DHT), dehydroepiandrosterone (DHEA), and dehydroepiandrosterone sulfate (DHEAS) were assessed with an in-house developed liquid chromatography tandem mass spectrometry (LC-MS/MS) method. The associations between the serum androgens and the hormone markers commonly used for evaluating ovarian reserve function, such as anti-mullerian hormone (AMH) and the ratio of luteinizing hormone (LH)/follicle stimulating hormone (FSH) were explored.
The serum T, FT, Bio-T, A2, DHT, DHEA, DHEAS, AMH and LH/FSH of the PCOS group were 51.7 ± 23.2 ng/dL/mL, 8.5 ± 5.0 pg/mL, 210.1 ± 127.7 pg/mL, 1.9 ± 0.8 ng/mL, 0.2 ± 0.1 ng/mL, 6.4 ± 4.2 ng/mL, 2431.0 ± 1030.7 ng/mL, 6.7 ± 3.8 ng/mL, and 1.8 ± 1.4 respectively, which were significantly higher than those in the non-PCOS group (<0.05). In the group of PCOS patients, T and A2 levels were positively associated with AMH in both multivariate linear regression analysis and Pearson's correlation analysis. Similar but weaker associations were observed in the non-PCOS patients. In the PCOS patients with hyperandrogenemia (HA), the AMH level was significantly higher in the subjects with T increased than in the subjects with non-T androgen(s) increased (A2, DHT, DHEA or DHEAS).
The serum androgen levels are positively associated with ovarian reserve markers in both of the PCOS and the non-PCOS patients in our study. In the PCOS group, the highest AMH level was observed in the subjects with the T elevation subgroup, suggesting that T is more closely related with the increase of AMH when compared with other androgens investigated.
高雄激素血症在多囊卵巢综合征（PCOS）患者的卵巢储备中作用仍不清楚。我们的研究强调了血清雄激素水平与 PCOS 和非 PCOS 妇女卵巢储备标志物的相关性。
2021 年 1 月至 2021 年 10 月，北京妇产医院回顾性评估了 584 名 20-45 岁月经异常的妇女。根据 Rotterdam 共识诊断 PCOS，将入组患者分为 PCOS 组（n=288）和非 PCOS 组（n=296）。采用我们开发的液相色谱串联质谱法（LC-MS/MS）测定血清雄激素，包括睾酮（T）、游离睾酮（FT，计算）、生物可利用睾酮（Bio-T，计算）、雄烯二酮（A2）、二氢睾酮（DHT）、脱氢表雄酮（DHEA）和硫酸脱氢表雄酮（DHEAS）。探讨了血清雄激素与常用的卵巢储备功能评估激素标志物（如抗苗勒管激素（AMH）和黄体生成素（LH）/卵泡刺激素（FSH）比值）之间的关系。
PCOS 组的血清 T、FT、Bio-T、A2、DHT、DHEA、DHEAS、AMH 和 LH/FSH 分别为 51.7±23.2ng/dL/mL、8.5±5.0pg/mL、210.1±127.7pg/mL、1.9±0.8ng/mL、0.2±0.1ng/mL、6.4±4.2ng/mL、2431.0±1030.7ng/mL、6.7±3.8ng/mL和 1.8±1.4，明显高于非 PCOS 组（<0.05）。在 PCOS 患者中，多元线性回归分析和 Pearson 相关分析均显示 T 和 A2 水平与 AMH 呈正相关。在非 PCOS 患者中也观察到类似但较弱的相关性。在 PCOS 患者中，高雄激素血症（HA）患者中 T 升高者的 AMH 水平明显高于非 T 雄激素（A2、DHT、DHEA 或 DHEAS）升高者。
在本研究中，血清雄激素水平与 PCOS 和非 PCOS 患者的卵巢储备标志物呈正相关。在 PCOS 组中，T 升高亚组的 AMH 水平最高，提示与所研究的其他雄激素相比，T 与 AMH 的升高更为密切相关。
