Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Research Unit of Clinical Medicine, University of Oulu and Oulu University Hospital, FI-90029, Oulu, Finland.
Institute of Reproductive and Developmental Biology, Imperial College London, W12 0NN, London, United Kingdom.
Eur J Endocrinol. 2023 Jun 7;188(6):547-554. doi: 10.1093/ejendo/lvad065.
Previous studies have shown good correlation between polycystic ovarian morphology (PCOM) and serum anti-Müllerian hormone (AMH) levels. We evaluated the utility of AMH as a surrogate for PCOM as a part of the polycystic ovary syndrome (PCOS) diagnosis by describing how the use of different AMH cut-off values would change the prevalence of PCOS.
A general population-based birth cohort study. Anti-Müllerian hormone concentrations were measured from serum samples taken at age 31 years (n = 2917) using the electrochemiluminescence immunoassay (Elecsys). Anti-Müllerian hormone data were combined with data on oligo/amenorrhoea and hyperandrogenism to identify women with PCOS.
The addition of AMH as a surrogate marker for PCOM increased the number of women fulfilling at least two PCOS features in accordance with the Rotterdam criteria. The prevalence of PCOS was 5.9% when using the AMH cut-off based on the 97.5% quartile (10.35 ng/mL) and 13.6% when using the recently proposed cut-off of 3.2 ng/mL. When using the latter cut-off value, the distribution of PCOS phenotypes A, B, C, and D was 23.9%, 4.7%, 36.6%, and 34.8%, respectively. Compared with the controls, all PCOS groups with different AMH concentration cut-offs showed significantly elevated testosterone (T), free androgen index (FAI), luteinizing hormone (LH), LH/follicle-stimulating hormone (FSH) ratio, body mass index (BMI), waist circumference, and homoeostatic model assessment of insulin resistance (HOMA-IR) values, as well as significantly decreased sex hormone-binding globulin (SHBG) values.
Anti-Müllerian hormone could be useful surrogate for PCOM in large data sets, where transvaginal ultrasound is not feasible, to aid the capturing of women with typical PCOS characteristics. Anti-Müllerian hormone measurement from archived samples enables retrospective PCOS diagnosis when combined with oligo/amenorrhoea or hyperandrogenism.
先前的研究表明多囊卵巢形态（PCOM）与血清抗苗勒管激素（AMH）水平之间存在良好的相关性。我们评估了 AMH 作为多囊卵巢综合征（PCOS）诊断中 PCOM 的替代指标的效用，方法是描述使用不同的 AMH 截断值如何改变 PCOS 的患病率。
这是一项基于一般人群的出生队列研究。使用电化学发光免疫分析法（Elecsys）从 31 岁时的血清样本中测量抗苗勒管激素浓度（n = 2917）。将 AMH 数据与月经稀少/闭经和高雄激素血症的数据相结合，以确定患有 PCOS 的女性。
将 AMH 作为 PCOM 的替代标志物添加后，符合鹿特丹标准的至少有两种 PCOS 特征的女性人数增加。当使用基于第 97.5%四分位数（10.35ng/ml）的 AMH 截断值时，PCOS 的患病率为 5.9%，当使用最近提出的 3.2ng/ml 截断值时，PCOS 的患病率为 13.6%。当使用后一个截断值时，PCOS 表型 A、B、C 和 D 的分布分别为 23.9%、4.7%、36.6%和 34.8%。与对照组相比，所有 AMH 浓度截断值不同的 PCOS 组的睾酮（T）、游离雄激素指数（FAI）、黄体生成素（LH）、LH/卵泡刺激素（FSH）比值、体重指数（BMI）、腰围和稳态模型评估的胰岛素抵抗（HOMA-IR）值均显著升高，而性激素结合球蛋白（SHBG）值显著降低。
在无法进行阴道超声的大型数据集，抗苗勒管激素可能是 PCOM 的有用替代指标，有助于捕捉具有典型 PCOS 特征的女性。将抗苗勒管激素测量值与月经稀少/闭经或高雄激素血症相结合，可从存档样本中进行回顾性 PCOS 诊断。
