The value of anti-Mullerian hormone in the management of polycystic ovary syndrome in adolescents

Abstract

A prospective study was carried out in 110 adolescents (13–19 years), 90 patients with polycystic ovary syndrome (PCOS) (study group) and 20 healthy adolescents (control group). The study group was divided into two: Group I – patients without insulin resistance (n = 30) and Group II – patients with insulin resistance (n = 60). Group I was treated with oral contraceptives (OCs), while Group II was divided into treatment subgroups of 20 patients each: Subgroup A received OCs; Subgroup B − myo-inositol; subgroup C – OCs + myo-inositol. Data were analyzed at baseline, 3 and 6 months of treatment. Results showed average anti-Mullerian hormone (AMH) levels were significantly higher in PCOS patients (11.8 ± 5.3 ng/ml) than in controls (2.98 ± 4.5 ng/ml). After treatment, in Group I and Group II Subgroup A: AMH, luteinizing hormone (LH), free testosterone (FT), total testosterone (T), Ov/v, antral follicle count (AFC), and Ferriman–Gallwey modified scale (mFG) significantly decreased, homeostatic model assessment-insulin resistance (HOMA-IR), body mass index (BMI) did not change significantly. In Group II Subgroup B only HOMA-IR and BMI significantly decreased; in Subgroup C all the parameters decreased significantly. The correlation between AMH and hormonal, morphological characteristics of ovaries were established. The results indicate that AMH could possibly be a valuable marker for the diagnosis of PCOS in adolescents, and for the assessment of treatment efficacy as well.

摘要

这是一项有110名青少年（13-19岁）参与的前瞻性研究, 其中多囊卵巢综合征（PCOS）患者（研究组）90例和健康青少年（对照组）20例。将研究组分为两部分：I组—无胰岛素抵抗的患者（n=30）和II组—有胰岛素抵抗的患者（n=60）。I组应用口服避孕药（OCs）进行治疗, 而II组按照治疗方法分为3个亚组, 每组20个患者：A亚组应用口服避孕药（OCs）治疗, B亚组应用肌醇治疗, C亚组应用口服避孕药+肌醇治疗。在基线、治疗后3个月、治疗后6个月进行数据分析。结果显示PCOS患者的抗苗勒管激素（AMH）平均水平（11.8±5.3ng / ml）显著高于对照组（2.98±4.5ng / ml）。治疗后, 在I组和II组A亚组中：AMH, 促黄体生成激素（LH）, 游离睾酮（FT）, 总睾酮（T）, Ov / v, 窦卵泡数（AFC）和改良Ferriman-Gallwey评分(mFG)明显降低。稳态模型评估-胰岛素抵抗（HOMA-IR）, 体重指数（BMI）没有明显变化。在II组B亚组中, 只有HOMA-IR和BMI明显降低。在C亚组中, 所有参数均显着降低。本研究建立了AMH与卵巢激素, 卵巢形态特征的相关性。结果表明, AMH可能成为青少年PCOS的诊断和评估其治疗效果有价值的标志物。

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 (PCOS)
• anti-Mullerian hormone (AMH)
• insulin resistance (IR)
• myo-inositol
• hyperandrogenism
• adolescent’s health

Disclosure statement

No potential conflict of interest was reported by the authors.