Zhao Han, Zhou Dexin, Liu Cong, Zhang Le
Department of Endocrinology, Shengjing Hospital, China Medical University, Shenyang, Liaoning, People's Republic of China.
Department of Endocrinology, Dalian Third People´s Hospital, Dalian, Liaoning, People's Republic of China.
Int J Womens Health. 2023 Feb 5;15:151-166. doi: 10.2147/IJWH.S393594. eCollection 2023.
Anti-Mullerian hormone (AMH) is vital in the pathophysiological process of polycystic ovary syndrome (PCOS). The exact relationship between obesity and insulin resistance (IR) with AMH levels remains unclear.
A retrospective, single-center cohort study of 220 women with PCOS who underwent physical, endocrine, and metabolic assessments were performed. Patients were grouped by age, body mass indices (BMI), Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), and different phenotypes. Pearson correlation analysis assessed the correlation between AMH and HOMA-IR, BMI, and other PCOS indicators, and multiple linear regression analysis was performed to determine factors influencing AMH.
In 220 patients with PCOS, serum AMH levels decreased with age and were significantly higher in the IR group than in the non-IR group ( < 0.01). AMH increased significantly in anovulatory patients with hyperandrogenemia and/or polycystic ovary, with no significant difference between obese and non-obese individuals. AMH levels correlated positively with luteinizing hormone (LH), LH/follicular stimulating hormone (FSH), testosterone, fasting insulin (FINS), and HOMA-IR levels; negatively with age and BMI levels ( < 0.05) and weakly with fasting plasma glucose in the classical PCOS phenotype (r=0.148, < 0.05). Regression analysis showed that age, testosterone, FINS, LH, LH/FSH, and BMI influenced AMH levels ( < 0.05).
Chinese women with PCOS-IR showed associations with greater AMH levels. AMH levels correlated positively with HOMA-IR levels and negatively with BMI. AMH combined with BMI and HOMA-IR levels may help determine PCOS severity.
抗苗勒管激素（AMH）在多囊卵巢综合征（PCOS）的病理生理过程中至关重要。肥胖和胰岛素抵抗（IR）与AMH水平之间的确切关系仍不清楚。
对220例接受了体格、内分泌和代谢评估的PCOS女性进行了一项回顾性单中心队列研究。患者按年龄、体重指数（BMI）、胰岛素抵抗稳态模型评估（HOMA-IR）以及不同表型进行分组。采用Pearson相关分析评估AMH与HOMA-IR、BMI及其他PCOS指标之间的相关性，并进行多元线性回归分析以确定影响AMH的因素。
在220例PCOS患者中，血清AMH水平随年龄下降，IR组显著高于非IR组（<0.01）。无排卵且伴有高雄激素血症和/或多囊卵巢的患者AMH显著升高，肥胖和非肥胖个体之间无显著差异。AMH水平与黄体生成素（LH）、LH/卵泡刺激素（FSH）、睾酮、空腹胰岛素（FINS）和HOMA-IR水平呈正相关；与年龄和BMI水平呈负相关（<0.05），在经典PCOS表型中与空腹血糖呈弱相关（r=0.148，<0.05）。回归分析显示年龄、睾酮、FINS、LH、LH/FSH和BMI影响AMH水平（<0.05）。
患有PCOS-IR的中国女性AMH水平较高。AMH水平与HOMA-IR水平呈正相关，与BMI呈负相关。AMH结合BMI和HOMA-IR水平可能有助于确定PCOS的严重程度。
