Application of anti-Müllerian hormone and hormone metabolic parameters in the diagnosis of polycystic ovary syndrome

Abstract

Objective To establish the threshold of anti-Mullerian hormone (AMH) and other hormone metabolic parameters for detection of polycystic ovary syndrome (PCOS) in China. Methods A total of 653 PCOS patients and 118 healthy controls were enrolled in this study. The serum AMH, follicle stimulating hormone (FSH), luteinizing hormone(LH), FSH/LH, prolactin (PRL), estradiol (E2), testosterone (T), dehydroepiandrosterone sulfate (DHEA-S), sex hormone binding globulin (SHBG), 17α-OH progesterone (17α-OHP), fasting insulin (INS), fasting glucose (GLU) and HOMA-IR were analyzed and the diagnostic utility of AMH, LH/FSH, T and INS were established using receiver operator characteristic (ROC) curves. With AMH, LH/FSH, T and INS as independent variables, the logistic regression model was established, and the ROC curve of joint detection was fitted by the probability value in the model. Results The serum level of FSH, LH, LH/FSH, AMH, free androgenindex (FAI), 17α-OHP, fasting INS, T, SHBG, DHEA-S and HOMA-IR were changed in PCOS. The best compromise between sensitivity and specificity was found at an AMH cut-off level of 8.16 μg/L, 6.98 μg/L and 5.65 μg/L, and the area under the curve for AMH identifying polycystic ovaries were 0.846, 0.845 and 0.832 for 20-29, 30-34 and 35-39 years old women, respectively. The area under ROC curve of joint detection was 0.951. Conclusion The cut-off level of AMH was 8.16 μg/L for PCOS during 20-29 years old, 6.98 μg/L for PCOS during 30-34 and 5.65 μg/L for PCOS during 35-39 years old women in China. Serum AMH, LH/FSH, T and INS had the capacity to act as a diagnostic test for PCOS. Combined detection of these markers can improve the diagnostic specificity and sensitivity of PCOS. Key words: Anti-Mullerian hormone (AMH); Polycystic ovary syndrome (PCOS); Hyperandrogenism; Insulin resistance