Alhassan Samia, Elmugadam Abdelgadir, Elfadil Ghada A, Abubaker Nuha, Elfaki Elyasa M, Hamza Alneil, Abdalhabib Ezeldine K, Karar Tarig
Department of Clinical Chemistry, College of Medical Laboratory Science, Sudan University of Science and Technology, Khartoum, Sudan.
Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Al-Qurayyat, Saudi Arabia.
Int J Womens Health. 2023 May 29;15:837-843. doi: 10.2147/IJWH.S403347. eCollection 2023.
Polycystic ovary syndrome (PCOS) is one of the most important contributing factors to infertility. The diagnosis of PCOS is not an easy procedure, as the signs and symptoms are heterogeneous and of undefined etiology. There are only a few published studies that address the diagnostic performance of anti-Müllerian hormone in diagnosis of PCOS in sub-Saharan Africa including Sudan.
This study aims to assess anti-Müllerian hormone (AMH), luteinizing to follicle-stimulating hormone ratio (LH: FSH), total testosterone (TT), and prolactin (PRL) levels among PCOS. In addition, we determine if AMH can be used as a predictor of PCOS among Sudanese women.
There were 600 women enrolled in this observational cross-sectional study, 300 of whom had PCOS, and 300 of whom healthy women; PCOS was diagnosed using the Rotterdam criteria. On days 2-4 of the menstrual cycle, serum LH, FSH, AMH, TT, and PRL levels were measured for all participants. Diagnostic performance of these parameters for PCOS was determined by receiver operating characteristic (ROC) curve.
Significantly higher means among PCOS regarding their BMI, AMH; LH: FSH ratio; TT; PRL, whereas significantly inverse in FSH compared with normal ovulatory women. On ROC analysis, AMH had the largest operating characteristic curve at cut-off >3.95 ng/mL; AUC = 0.999 with Youden's index 0.99%, followed by LH: FSH ratio at cut-off 0.749; AUC=0.932; Youden's index 0.813%, TT cut-off 0.82 mIU/L, AUC=0.852 with Youden's index 0.58, while PRL showed the lowest AUC=0.627 with cut-off 15.3 ng/mL, Youden's index was 0.18%, P. value<0.001.
Sudanese women with PCOS had higher serum AMH level, LH:FSH ratio, and TT level. Moreover, AMH level has better discriminative power and good diagnostic potency for the diagnosis of PCOS among Sudanese.
多囊卵巢综合征（PCOS）是导致不孕的最重要因素之一。PCOS的诊断并非易事，因为其体征和症状具有异质性且病因不明。在撒哈拉以南非洲地区（包括苏丹），仅有少数已发表的研究探讨了抗苗勒管激素在PCOS诊断中的诊断效能。
本研究旨在评估PCOS患者中抗苗勒管激素（AMH）、黄体生成素与促卵泡生成素比值（LH:FSH）、总睾酮（TT）和催乳素（PRL）水平。此外，我们还确定AMH是否可作为苏丹女性PCOS的预测指标。
本观察性横断面研究纳入了600名女性，其中300名患有PCOS，300名是健康女性；PCOS采用鹿特丹标准进行诊断。在月经周期的第2 - 4天，测量所有参与者的血清LH、FSH、AMH、TT和PRL水平。通过受试者工作特征（ROC）曲线确定这些参数对PCOS的诊断效能。
PCOS患者的BMI、AMH、LH:FSH比值、TT、PRL均值显著更高，而与正常排卵女性相比，FSH显著更低。在ROC分析中，AMH在临界值>3.95 ng/mL时具有最大的操作特征曲线；曲线下面积（AUC）=0.999，约登指数为0.99%，其次是LH:FSH比值，临界值为0.749时，AUC = 0.932，约登指数为0.813%，TT临界值为0.82 mIU/L，AUC = 0.852，约登指数为0.58，而PRL的AUC最低，为0.627，临界值为15.3 ng/mL，约登指数为0.18%，P值<0.001。
患有PCOS的苏丹女性血清AMH水平、LH:FSH比值和TT水平更高。此外，AMH水平在苏丹人群中对PCOS的诊断具有更好的鉴别能力和良好的诊断效力。
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