Abstract
ObjectiveWe intended to establish the threshold for anti-Mullerian hormone (AMH) in the diagnosis of polycystic ovary syndrome (PCOS) in China.MethodsA total of 771 women (653 with PCOS and 118 healthy controls) were enrolled. The serum AMH, follicle-stimulating hormone (FSH), luteinizing hormone (LH), FSH/LH, prolactin, estradiol, testosterone (T), dehydroepiandrosterone sulfate (DHEA-S), sex hormone-binding globulin (SHBG), 17α-OH progesterone (17α-OHP), fasting insulin (INS), fasting glucose, free androgen index (FAI%) and homeostasis model assessment for insulin resistance (HOMA-IR) index were analyzed, and the diagnostic utility of AMH, LH/FSH, T and INS was established using receiver operator characteristic (ROC) curves. With AMH, LH/FSH, T and INS as independent variables, a logistic regression model was established, and the ROC curve for combined detection was fitted with the probability value of the model.ResultsThe serum level of FSH, LH, LH/FSH, AMH, FAI%, 17α-OHP, fasting INS, T, SHBG, DHEA-S and HOMA-IR were altered in the PCOS patients. The best compromise between sensitivity and specificity was found at an AMH cut-off level of 8.16 ng/ml and 5.89 ng/ml for the age groups 20–29 and 30–39 years, with the corresponding area under the curve being 0.846 and 0.865 respectively. The area under the ROC curve for combined detection was 0.951, which was significantly greater than that of each index. Finally, the concentration of AMH was associated with FSH, LH, LH/FSH, T, and ovarian volume in PCOS patients.ConclusionThe optimal AMH diagnostic threshold for PCOS was 8.16 ng/ml (20–29 years) and 5.89 ng/ml (30–39 years) in the Chinese population of this study. Moreover, serum AMH, LH/FSH, T and INS could be used in combination to improve the diagnostic specificity and sensitivity for the detection of PCOS.
Highlights
Polycystic ovary syndrome (PCOS) is a common reproductive endocrine disease that is prevalent in 6% of women of childbearing age [1]
The serum level of follicle-stimulating hormone (FSH), luteinizing hormone (LH), LH/FSH, Anti-Mullerian hormone (AMH), free androgen index (FAI)%, 17α-OH progesterone (17α-OHP), fasting INS, T, sex hormonebinding globulin (SHBG), DHEAS and homeostasis model assessment for insulin resistance (HOMA-IR) were altered in the PCOS patients
The concentration of AMH was associated with FSH, LH, LH/FSH, T, and ovarian volume in PCOS patients
Summary
Polycystic ovary syndrome (PCOS) is a common reproductive endocrine disease that is prevalent in 6% of women of childbearing age [1]. Polycystic ovary syndrome (PCOS) is a common endocrine disease that is clinically manifested as menstrual thinning, hemorrhoids, hairiness, obesity and infertility. It is characterized by abnormal levels of reproductive hormones, which can lead to anovulatory, infertile and menstrual disorders [2]. Most probably in women too, AMH does not regulate primordial follicle growth. It stimulates primary and secondary follicle growth, in contrast to its inhibitory role in female rodents. Women without PCOS who have high AMH levels are commonly very fertile
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