Correlation of body mass index (BMI), anti-mullerian hormone (AMH), and insulin resistance among different polycystic ovary syndrome (PCOS) phenotypes – a cross-sectional study

Abstract

One hundred and fifty infertile polycystic ovary syndrome (PCOS) women were classified into four phenotypes on the basis of Rotterdam criteria. Homeostatic model assessment of insulin resistance (HOMA-IR) with a cutoff ≥2.5 was considered as a measure of insulin resistance (IR). Maximum number of patients, 57 (38%) in our cohort belonged to phenotype A or the classical phenotype with all 3 features of Rotterdam criteria. Mean body mass index (BMI) in all phenotypes was more than 25 kg/m² and the highest was seen in phenotype B. According to BMI categories in the four phenotypes, more number of women was in the obese category in phenotype A (24.5%) and B (56.5%) in comparison to phenotype C (18.2%) and D (10.8%) (p<.001). There was no difference in median HOMA-IR among different phenotype categories (p=.718). The median value of anti-mullerian hormone (AMH) was highest in phenotype A (11.68 ng/ml [7.94–16.46]) and significantly more in comparison to B phenotype (Kruskal–Wallis, p=.018). Thus there is heterogeneity in AMH levels and BMI in different PCOS phenotypes with higher levels in the most severe phenotypes. There is, however, no correlation of IR among the different phenotype groups and further investigation is needed to characterize its role in phenotypic classification.

摘要

根据鹿特丹标准将150名不育的多囊卵巢综合征（PCOS）患者分为4种表型。胰岛素抵抗的稳态模型评估指数(HOMA-IR)≥2.5认为存在胰岛素抵抗。队列中大多数患者57（38％）属于表型A或具有鹿特丹标准3个特征的经典表型。所有表型的平均身体质量指数（BMI）均超过25 kg / m2, 其中表型B的平均身体质量指数最高。在四种表型中根据BMI分类, 与C型（18.2％）和D型（10.8％）相比, A型（24.5％）和B型（56.5％）中的肥胖女性更多(p<.001)。不同表型之间的HOMA-IR中位数没有差异（p=.718）。 表型A抗苗勒氏管激素（AMH）中位数最高（11.68ng/ml[7.94–16.46]）, 与表型B相比差异最大（Kruskal–Wallis, p =.018）。因此, 不同PCOS表型的AMH水平和BMI存在异质性, 而在最严重的表型中其水平较高。 然而IR在不同的表型组之间没有相关性, 需要进一步研究探索其在表型分类中的作用。

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:

• PCOS phenotype
• insulin resistance
• anti-mullerian hormone
• body mass index

Acknowledgments

We acknowledge the contribution of the reproductive biology laboratory of the hospital where all the blood tests of the patients were done.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The authors state that no funding was received from any agency for conduct of this study.