Institute of Neuroscience and Physiology, Department of Physiology, Sahlgrenska Academy, University of Gothenburg, Box 430, 405 30, Gothenburg, Sweden.
Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Gothenburg, Sweden.
Reprod Biol Endocrinol. 2022 Oct 29;20(1):153. doi: 10.1186/s12958-022-01022-0.
Women with polycystic ovary syndrome (PCOS) have high circulating anti-Müllerian hormone (AMH) levels which is correlated with antral follicle count and polycystic ovarian morphology and negatively correlated with body mass index (BMI). Moreover, diet-induced weight loss in women with PCOS and overweight or obesity, reduce or normalize AMH-levels. There is, however, no previous study investigating the circulating AMH levels in women with severe obesity and how a structured diet-induced weight loss program affects circulating AMH levels in these women. Therefore, this study aims to investigate circulating AMH levels in a population of women with severe obesity (BMI ≥ 35 kg/m) with and without PCOS, as diagnosed by the NIH-criteria, and to investigate the effect of a one-year weight loss program with a very low-energy diet (VLED) on circulating levels of AMH.
In a prospective cohort-study, were 246 women with severe obesity were screened for PCOS diagnosis with the NIH-criteria, circulating AMH and anthropometry were measured at baseline and after a 12-month weight loss intervention with very low-energy diet (VLED).
Mean BMI was 39.9 ± 4.7 (PCOS), 39.6 ± 4.3 (non-PCOS) P = 0.960. Circulating AMH was higher in women with PCOS (5.47 ± 4.89 µg/L) compared with non-PCOS (2.66 ± 3.71 µg/L) P < 0.001 and was positively correlated with circulating total testosterone in both groups. Next, we performed ROC-analyses, and show that circulating AMH could not discriminate women with PCOS and severe obesity from non-PCOS women with severe obesity. Finally, a one-year weight reduction program does not affect circulating AMH levels despite significant weight loss neither in women with PCOS, nor without PCOS and severe obesity.
Women with severe obesity and PCOS have elevated levels of circulating AMH compared to women without the syndrome. AMH-levels could not discriminate women with PCOS from non-PCOS because of low sensitivity and specificity. Significant weight loss was not associated with changes in circulating AMH levels, neither in women with, nor without PCOS and severe obesity. These results imply that in women with severe obesity, a greater weight loss may be needed to improve reproductive features, independent of PCOS diagnosis.
Clinical trial.gov: NCT01319162.
患有多囊卵巢综合征（PCOS）的女性循环中的抗苗勒氏管激素（AMH）水平较高，这与窦卵泡计数和多囊卵巢形态有关，与体重指数（BMI）呈负相关。此外，患有 PCOS 和超重或肥胖的女性通过饮食诱导体重减轻，可以降低或使 AMH 水平正常化。然而，以前没有研究调查过患有严重肥胖的女性的循环 AMH 水平，以及结构化的饮食诱导体重减轻计划如何影响这些女性的循环 AMH 水平。因此，本研究旨在调查患有严重肥胖（BMI≥35kg/m）的女性中，患有和不患有多囊卵巢综合征（根据 NIH 标准诊断）的女性的循环 AMH 水平，并调查为期一年的极低能量饮食（VLED）减肥计划对 AMH 循环水平的影响。
在一项前瞻性队列研究中，对 246 名患有严重肥胖症的女性进行了筛查，以根据 NIH 标准诊断 PCOS，在基线时和经过 12 个月的极低能量饮食（VLED）减肥干预后测量循环 AMH 和人体测量学。
平均 BMI 为 39.9 ± 4.7（PCOS），39.6 ± 4.3（非 PCOS），P=0.960。患有 PCOS 的女性的循环 AMH 水平（5.47 ± 4.89µg/L）高于非 PCOS 女性（2.66 ± 3.71µg/L），P<0.001，且与两组的循环总睾酮呈正相关。接下来，我们进行了 ROC 分析，结果表明循环 AMH 不能区分患有 PCOS 和严重肥胖的女性与患有严重肥胖的非 PCOS 女性。最后，尽管患有 PCOS 和严重肥胖的女性和没有 PCOS 和严重肥胖的女性都显著减轻了体重，但为期一年的减肥计划并没有影响循环 AMH 水平。
与没有该综合征的女性相比，患有严重肥胖症和 PCOS 的女性循环中的 AMH 水平较高。由于敏感性和特异性较低，AMH 水平不能区分患有 PCOS 的女性和非 PCOS 女性。显著的体重减轻与循环 AMH 水平的变化无关，无论女性是否患有 PCOS 和严重肥胖。这些结果表明，在患有严重肥胖的女性中，可能需要更大程度的体重减轻才能改善生殖特征，而与 PCOS 的诊断无关。
Clinicaltrial.gov：NCT01319162。
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