Evaluation of AMH and INHB in the diagnosis of polycystic ovary syndrome

Abstract

Objective To assess the clinical diagnosis value and treatment effect of anti-Mullerian hormone (AMH) and inhibin B (INHB) in polycystic ovary syndrome (PCOS) patients. Methods Total of 300 cases of PCOS patients were enrolled in this study from January 2014 to January 2016 in the First Affiliated Hospital, Hunan University of Chinese Medicine, and those patients were randomly divided into group A, group B and group C. There were 100 patients in every group. The patients in group A were interfered by traditional Chinese medicine. The patients in group B were treated with Western medicine and those in group C were treated with traditional Chinese medicine combined with western medicine. Total of 264 cases health volunteers were enrolled as the control group. The effect was evaluated. The level of AMH and INHB in serum of PCOS patients were detected by chemiluminescent assay before treatment and three months after treatment. Results The cutoffs of AMH and INHB were 6.98 ng/ml and 150 pg/ml, respectively. The AUC of AMH combined with INHB was significantly larger than that of AMH or INHB(0.945 vs. 0.859, 0.945 vs. 0.784). In the PCOS group, the positive PCOS rate of AMH combined with INHB was significantly larger than that of AMH or INHB[87.00%(261/300) vs. 83.33%(250/300) vs.93.67%(281/300), χ2=15.593, P=0.000]. The sensitivity[93.67%(281/300)], specificity[92.42%(244/264)], positive predictive value[93.36%(281/288)], negative predictive value[92.78%(244/264)]and Jordanian index(0.659) of AMH combined with INHB was significantly larger than that of AMH[87.00%(261/300), 87.88%(232/264), 89.08%(261/293), 85.61%(232/271) and 0.612]or INHB[83.33%(250/300), 90.15%(238/264), 90.58%(250/276), 82.64%(238/301) and 0.571]. After treatment, AMH[(9.06±2.13)ng/ml vs. (6.34±1.12)ng/ml, t=10.595, P=0.000; (9.08±2.08)ng/ml vs. (6.02±1.02)ng/ml, t=13.209, P=0.000; (9.13±2.31)ng/ml vs. (3.53±0.83)ng/ml, t=22.814, P=0.000]and INHB[(173.13±14.22)pg/ml vs. (145.26±13.05)pg/ml, t=14.440, P=0.000; (174.28±13.82)pg/ml vs. (145.39±12.98) pg/ml, t=15.238, P=0.000; (174.98±13.77)pg/ml vs. (133.15±12.04)pg/ml, t=22.869, P=0.000]in 3 groups had decreased. After treatment, the AMH of group C [(3.53±0.83)ng/ml] was significantly lower than that of group A and B[(6.34±1.12)ng/ml and (6.02±1.02)ng/ml, F=237.936, P=0.000], and the level of AMH in group C [(133.15±12.04) pg/ml] was significantly lower than that in both group A and group B[(145.26±13.05)pg/ml and (145.39±12.98)pg/ml, F=30.645, P=0.000]. Conclusions AMH combined with INHB can be used to diagnose PCOS. AMH and INHB can be used to evaluate PCOS efficacy.(Chin J Lab Med, 2017, 40: 391-395) Key words: Polycystic ovary syndrome; Anti-mullerian mormone; Inhibins; Treatment outcome