Hormone profiling, including anti-Müllerian hormone (AMH), for the diagnosis of polycystic ovary syndrome (PCOS) and characterization of PCOS phenotypes

Abstract

Objective was to evaluate serum anti-Müllerian hormone (AMH) levels in polycystic ovary syndrome (PCOS) and in its different phenotypes in relation to clinical, endocrine and metabolic parameters using a new automated VIDAS^® method and to compare it with the Gen II method. Study design was multi-center study including 319 PCOS women and 109 healthy controls. Serum AMH levels measured using VIDAS^® were significantly higher in PCOS women than controls (p < .001), and they correlated with those measured using the AMH Gen II method. An AMH cutoff value of 42.1 pmol/L distinguished PCOS women from controls with 67% sensitivity and 83% specificity. The PCOS women with three Rotterdam criteria or hyperandrogenism displayed significantly higher AMH levels compared with those with two Rotterdam criteria or normoandrogenism. In PCOS, AMH levels correlated positively with luteinizing hormone (LH), androgen and sex hormone-binding globulin (SHBG) levels and negatively with BMI, abdominal obesity, follicle-stimulating hormone (FSH), fasting glucose and insulin, and insulin resistance. In conclusion, AMH evaluated using the VIDAS^® method distinguished PCOS patients from healthy controls relatively well, especially in those with more severe phenotypes. Further studies are needed to establish whether AMH measurements can distinguish PCOS patients with different metabolic risk factors.

摘要

目的是应用新的自动VIDASVR方法评估多囊卵巢综合征（PCOS）患者血清抗苗勒管激素（AMH）水平及与临床、内分泌和代谢参数相关的不同表型PCOS患者的AMH水平, 并将其与Gen II方法进行比较。研究设计是多中心研究, 包括319名PCOS女性和109名健康对照。应用VIDASVR法测量的血清AMH水平在PCOS女性中显著高于对照组（p <0.001）, 并且它们与应用AMH Gen II方法测量值相关。AMH临界值为42.1 pmol/L, 以敏感性为67％, 特异性为83％将PCOS女性与对照组区别开。与具有两个鹿特丹标准或正常雄激素的患者相比, 具有三种鹿特丹标准或雄激素过多症的PCOS女性AMH水平显著更高。在PCOS中, AMH水平与黄体生成素（LH）、雄激素和性激素结合球蛋白（SHBG）水平呈正相关, 与BMI、腹型肥胖、卵泡刺激素（FSH）、空腹血糖和胰岛素以及胰岛素抵抗呈负相关。总之, 应用VIDASVR方法评估的AMH相对较好地区分PCOS患者和健康人, 特别是那些具有更严重表型的患者。需要进一步研究以确定AMH测量是否可以区分具有不同代谢风险因子的PCOS患者。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Polycystic ovary syndrome
• anti-Müllerian hormone
• hyperandrogenism
• phenotype of PCOS
• metabolic risks

Acknowledgments

We would like to thank bioMérieux for providing the laboratory assay kits.

Disclosure statement

Laure Morin-Papunen has received speaker’s fees for delivering lectures to bioMérieux personnel. The other authors have no conflict of interest to declare.

Additional information

Funding

This study was supported by Sigrid Juselius Foundation under Grant 39-3487-64; The Academy of Finland under Grants 315921 and 295760; and Medical Research Center Oulu.