Keum Jihyun, Kim Yong Jin, Choi Sae Kyung, Lee Won Moo, Bae Jaeman
Department of Obstetrics and Gynecology, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea.
Department of Obstetrics and Gynecology, Korea University Medical College, Seoul 02841, Republic of Korea.
J Pers Med. 2024 Feb 29;14(3):274. doi: 10.3390/jpm14030274.
Polycystic ovarian syndrome (PCOS) can be diagnosed when the anti-Müllerian hormone (AMH) levels are high, but in clinic, women who do not meet the diagnosis of PCOS but have elevated AMH levels are often seen. This study aimed to compare the differences in menstrual cycle patterns and hormone levels in women with regular menstrual cycles, but not PCOS, by dividing them into high and low AMH groups.
This multicenter prospective study included 68 healthy women. Participants with regular menstrual cycles were divided into two groups according to their AMH levels. The main outcome measures were menstrual cycle pattern, body mass index, and hormone levels (thyroid stimulating hormone, prolactin, testosterone, sex hormone-binding globulin, and free androgen index), which were compared between the groups according to AMH levels. The ovulation was assessed by performing pelvic ultrasound, and by assessing the hormone levels of the luteinizing hormone and progesterone.
The criteria for determining normal and high AMH levels were based on previous literatures. The participants were divided into normal (39 people) and high (29 people) AMH group. No differences were found in age or BMI between the two groups, and no other differences were observed in TSH, prolactin, testosterone, or free androgen index. However, the high AMH group had significantly higher SHBG levels than the normal group (normal group: 65.46 ± 25.78 nmol/L; high group: 87.08 ± 45.05 nmol/L) ( = 0.025).
This study is the first to analyze the association between SHBG and AMH levels in women with regular menstrual cycles. Elevated AMH levels are associated with increased levels of SHBG levels.
当抗苗勒管激素（AMH）水平升高时可诊断为多囊卵巢综合征（PCOS），但在临床上，常可见到不符合PCOS诊断标准但AMH水平升高的女性。本研究旨在通过将月经周期规律但非PCOS的女性分为AMH水平高、低两组，比较她们月经周期模式和激素水平的差异。
这项多中心前瞻性研究纳入了68名健康女性。月经周期规律的参与者根据其AMH水平分为两组。主要观察指标为月经周期模式、体重指数和激素水平（促甲状腺激素、催乳素、睾酮、性激素结合球蛋白和游离雄激素指数），根据AMH水平在两组之间进行比较。通过盆腔超声检查以及评估促黄体生成素和孕酮的激素水平来评估排卵情况。
确定正常和高AMH水平的标准基于既往文献。参与者被分为正常AMH组（39人）和高AMH组（29人）。两组之间在年龄或体重指数方面未发现差异，在促甲状腺激素、催乳素、睾酮或游离雄激素指数方面也未观察到其他差异。然而，高AMH组的性激素结合球蛋白水平显著高于正常组（正常组：65.46±25.78 nmol/L；高组：87.08±45.05 nmol/L）（P = 0.02）。
本研究首次分析了月经周期规律女性中SHBG与AMH水平之间的关联。AMH水平升高与SHBG水平升高相关。
