Sumji Sajad, Bhat Abid, Rashid Aafia, Bashir Rohina, Wani Imtiyaz A, Vasudevan Vishnu, Sehar Tajali, Ganie Mohd Ashraf
Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir India.
Department of Clinical Research, Sher-i-Kashmir Institute of Medical Sciences, 190011 Srinagar, India.
Indian J Clin Biochem. 2023 Oct;38(4):457-465. doi: 10.1007/s12291-022-01058-4. Epub 2022 Sep 6.
Anti-mullerian hormone (AMH) has been proposed to add significance to diagnosis of PCOS in case of ambiguity. However, variable cutoffs of AHM among PCOS women have been reported. Using case-control design, this study investigated the diagnostic threshold of serum AMH levels among age matched 113 PCOS and 75 normo-ovulatory women and its correlation with clinical, hormonal and ultrasonographic parameters.PCOS was defined as per Rotterdam criteria 2003. Results depicted the mean serum AMH level to be significantly higher in PCOS group (7.84 ± 3.67vs. 3.23 ± 1.56 ng/mL) than controls. The AMH levels were positively(p = 0.001) associated with ovarian volume (r = 0.521) as well as number of ovarian follicles(r = 0.461). Further, serum AMH levels showed a positive correlation with luteinizing hormone/follicle stimulating hormone (LH/FSH) ratio (r = 0.206, p = 0.02), but no correlation significant with age, BMI,FG score and testosterone levels. As per receiver operating characteristic (ROC) curve, cut-off was worked out to be 3.76 ng/ml with 86.7% sensitivity and 62.7% specificity. The mean level of AMH were highest among PCOS women with phenotype A (12.67 ± 3.46 ng/ml) with least among PCOS women displaying phenotype B(7.28 ± 1.60 ng/ml) where there is absence of PCOM. In conclusion, serum AMH levels are highly predictive of PCOM and high LH/FSH ratio among PCOS women and may be a potent diagnostic marker of ovarian dysfunction either alone or in conjunction with other tools.
The online version contains supplementary material available at 10.1007/s12291-022-01058-4.
抗苗勒管激素（AMH）已被提议在诊断不明确的情况下增加多囊卵巢综合征（PCOS）诊断的重要性。然而，有报道称PCOS女性中AMH的截断值存在差异。本研究采用病例对照设计，调查了113例年龄匹配的PCOS女性和75例排卵正常女性血清AMH水平的诊断阈值及其与临床、激素和超声参数的相关性。PCOS按照2003年鹿特丹标准定义。结果显示，PCOS组血清AMH平均水平（7.84±3.67 vs. 3.23±1.56 ng/mL）显著高于对照组。AMH水平与卵巢体积（r = 0.521）以及卵泡数量（r = 0.461）呈正相关（p = 0.001）。此外，血清AMH水平与黄体生成素/卵泡刺激素（LH/FSH）比值呈正相关（r = 0.206，p = 0.02），但与年龄、体重指数、FG评分和睾酮水平无显著相关性。根据受试者工作特征（ROC）曲线，得出截断值为3.76 ng/ml，敏感性为86.7%，特异性为62.7%。AMH平均水平在A型PCOS女性中最高（12.67±3.46 ng/ml），在无多囊卵巢形态（PCOM）的B型PCOS女性中最低（7.28±1.60 ng/ml）。总之，血清AMH水平对PCOS女性中的PCOM和高LH/FSH比值具有高度预测性，可能是卵巢功能障碍的有效诊断标志物，可单独使用或与其他工具联合使用。
在线版本包含可在10.1007/s12291-022-01058-4获取的补充材料。
