Is anti-Mullerian hormone a useful biomarker in the diagnosis of polycystic ovary syndrome in Chinese adolescents?

Abstract

Objective

(1) To investigate anti-Mullerian-hormone (AMH) in adolescents with polycystic ovary syndrome (PCOS) compared to age-matched girls without PCOS; (2) to determine whether AMH is a valuable marker for diagnosing PCOS and to explore the best cutoff value in adolescents; (3) using a multivariate predictive model for the diagnosis of PCOS.

Methods

Ninety girls (aged 10–20 years) recruited during two years for the PCOS-group (n = 45) or control-group (n = 45). PCOS diagnostic criteria according guidelines of the Endocrinology Expert Group, Obstetrics/Gynecology Branch of the Chinese Medical Association. Serum AMH and other sex hormones were measured. Logistic regression analysis to estimate the odds ratio of AMH and other variables for the diagnosis of PCOS. Receiver operator characteristics (ROC) curve analysis was performed to reveal the diagnostic potential.

Results

(A) AMH was significantly higher in PCOS patients than in controls (10.21 ± 5.85 ng/ml vs. 4.31 ± 2.84 ng/ml, p < .001). In PCOS-group, total testosterone (TT), free testosterone (FT) and biologically active testosterone (BioT) were significantly higher than in controls (p < .001). (B) Logistic regression suggests that AMH and TT are correlated with the diagnosis of PCOS (p < .05). (C) ROC curve analyses demonstrated that the optimal value of AMH for predicting PCOS was 6.32 ng/mL, with 69.8% sensitivity and 80.5% specificity. Furthermore, AMH combined with TT can provide 83.7% sensitivity and 80.5% specificity for diagnosing PCOS in adolescents.

Conclusions

AMH may be a useful biomarker for the diagnosis of PCOS in Chinese adolescent girls. A cutoff value of 6.32 ng/mL best discriminated between PCOS patients and controls. Besides AMH a multivariate predictive model should include TT.

抗苗勒管激素是诊断中国青少年多囊卵巢综合征的有用生物标志物吗？ 摘要

目的: (1)比较多囊卵巢综合征(PCOS)青少年与非PCOS青少年的抗苗勒氏管激素(AMH)水平; (2)确定AMH是否是诊断PCOS的有价值的指标, 探讨青少年多囊卵巢综合征(PCOS)的最佳临界值; (3)应用多变量预测模型诊断PCOS。

方法:在两年内招募90名女孩(年龄10-20岁), 随机分为PCOS组(45例)和对照组(45例)。根据中华医学会妇产科内分泌学分会专家指南制定PCOS的诊断标准。测定血清AMH和其他性激素水平。采用Logistic回归分析估计AMH和其他变量的比值比, 用于诊断PCOS。受试者特征(ROC)曲线分析揭示诊断潜力。

结果: (A)多囊卵巢综合征患者AMH明显高于对照组(10.21 ± 5.85 ng/ml 与4.31 ± 2.84 ng/ml, p < 0.001)。PCOS组总睾酮(TT)、游离睾酮(FT)和生物活性睾酮(BioT)均显著高于对照组(p < 0.001)。(B) Logistic回归提示AMH和TT与PCOS的诊断有关(p < 0.05)。(C) ROC曲线分析表明, AMH预测PCOS的最佳值为6.32 ng/mL, 敏感性为69.8%, 特异性为80.5%。AMH联合TT诊断PCOS的敏感性为83.7%, 特异性为80.5%。

结论: AMH可能是中国青春期女性多囊卵巢综合征(PCOS)诊断的一个有用的生物标志物。多囊卵巢综合征患者与对照组的最佳截断值为6.32 ng/mL。除了AMH, 多变量预测模型应包括TT。

Keywords:

• Anti-Mullerian hormone
• polycystic ovary syndrome
• adolescents

Acknowledgment

The authors especially thank Prof. Xingming Li of Capital Medical University (Beijing, China) for his assistance in the data's statistical analysis.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by Beijing Municipal Administration of Hospitals’ Ascent Plan (No. DFL20181401).