Abstract
BackgroundObesity is a state of excess body fat accumulation, and appears to be closely associated with polycystic ovary syndrome (PCOS). Notably, plausible biological pathways through which obesity can regulate anti-Müllerian hormone (AMH) production have been proposed, and women with PCOS characteristically have an increased AMH level. Body fat accumulation can be described by body fat percentage (BFP). However, the relationship between BFP and AMH still remains unclear.Materials and MethodsA total of 87 controls and 156 PCOS patients were divided into lean and overweight/obese groups, and the PCOS patients were further divided into hyper-AMH and normal-AMH subgroups. Univariate regression was used to assess the unadjusted relationship between AMH and outcome variables, multivariable regression analysis was performed to test whether and how serum AMH levels were associated with BFP after adjusting for other co-variables. Receiver-operating characteristic (ROC) curve analyses were used to test the utility of BFP for the diagnosis of PCOS.ResultsBFP was higher in PCOS patients compared with controls, regardless of obesity. Serum AMH levels were negatively associated with BFP in the PCOS group (r = -0.371; P < 0.001) but not in the control group (r = -0.095; P = 0.385). Multivariable logistic regression analysis showed that elevated BFP was associated with a high risk of PCOS (odds ratio, 1.290; 95% confidence interval, 1.084–1.534, P = 0.004). Furthermore, the combination of BFP and serum AMH into a multivariate model gave an improved area under the curve (AUC) of 88.5%, with a sensitivity of 72.4% and specificity of 87.4%; the positive and negative predictive values were 91.2% and 63.9%, respectively. One limitation of this study is all the conclusion reported was based on small sample size.ConclusionsHerein, we described the negative correlation between BFP and serum AMH levels for the first time, and the present results highlight the importance of further investigation into the role of BFP, especially in body fat-related AMH change as it relates to the underlying pathogenesis of PCOS.
Highlights
Polycystic ovary syndrome (PCOS) is a common endocrine disorder that affects up to 5%–20% of women of reproductive age; and is characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology [1]
body fat percentage (BFP) was significantly higher in the PCOS group than in the control group (Figure 1A), and similar results were seen for anti-Müllerian hormone (AMH) (Figure 1B)
Waist–hip ratio and fat mass were greater in the lean PCOS group than in the lean controls, and visceral fat was higher in the PCOS group with obesity
Summary
Polycystic ovary syndrome (PCOS) is a common endocrine disorder that affects up to 5%–20% of women of reproductive age; and is characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology [1]. A state of excess body fat accumulation, appears to be closely associated with PCOS [3]. Several studies have shown that AMH expression remains high until a follicle reaches a diameter of approximately 8 mm [10] It was introduced as a surrogate measure of polycystic ovaries and as a biomarker of PCOS because of its associations with other PCOS criteria, including oligomenorrhea and hyperandrogenism [11, 12]. Obesity is a state of excess body fat accumulation, and appears to be closely associated with polycystic ovary syndrome (PCOS). Plausible biological pathways through which obesity can regulate anti-Müllerian hormone (AMH) production have been proposed, and women with PCOS characteristically have an increased AMH level. The relationship between BFP and AMH still remains unclear
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