Anti-Mullerian hormone levels reflect severity of PCOS but are negatively influenced by obesity: relationship with increased luteinizing hormone levels
Anti-Mullerian hormone levels reflect severity of PCOS but are negatively influenced by obesity: relationship with increased luteinizing hormone levels
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DOI：
10.1152/ajpendo.90684.2008
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发表时间：
2009-02-01
影响因子：
5.1
通讯作者：
Panidis, Dimitrios
中科院分区：
文献类型：
--
作者：
Piouka, Athanasia;Farmakiotis, Dimitrios;Panidis, Dimitrios
Piouka A，Farmakiotis D，Katsikis I，Macut D，Gerou S，Panados D.抗苗勒管激素水平反映了PCOS的严重程度，但受到肥胖的负面影响：与黄体生成素水平升高的关系。Am J Physiol Endocrinol Metab 296：E238-E243，2009.首次发表于2008年10月28日; doi：10.1152/ajpendo.90684.2008。该研究的目的是比较肥胖或超重和正常体重的四种不同多囊卵巢综合征（PCOS）表型的女性和健康对照受试者的抗苗勒管激素（AMH）水平。AMH水平在四个年龄和体重指数（BMI）匹配的组中进行评估，每组25名正常体重和25名肥胖或超重妇女，属于该综合征的四个主要亚组，这些亚组由三个诊断标准的组合产生[第1组：超声评估的少排卵和/或无排卵（ANOV）、高雄激素血症（HA）和多囊卵巢（PCO）;第2组：ANOV和HA;第3组：HA和PCO，第4组：和50例（25例肥胖或超重和25例正常体重）年龄和BMI匹配的健康对照受试者。分析年龄、BMI、腰围、FSH、LH、催乳素、睾酮、δ（4）-雄烯二酮、硫酸脱氢表雄酮、17 α-OH-孕酮、空腹胰岛素、血糖、AMH、游离雄激素指数和胰岛素抵抗指数的稳态模型评估。PCOS组1和2的AMH水平显著高于组3和4以及对照组，PCOS组3和4的AMH水平显著高于对照组。AMH水平显着增加正常体重与肥胖和超重的妇女相比。根据LH和睾酮水平、BMI（阴性）和直径为2-9 mm的卵泡总数，按显著性顺序独立预测AMH浓度。PCOS女性主要表型组之间的循环AMH水平差异似乎反映了综合征的严重程度，但受肥胖的负面影响。LH水平升高可能是PCOS相关排卵障碍与观察到的AMH循环浓度升高之间最重要的独立联系。
Piouka A, Farmakiotis D, Katsikis I, Macut D, Gerou S, Panidis D. Anti-Mullerian hormone levels reflect severity of PCOS but are negatively influenced by obesity: relationship with increased luteinizing hormone levels. Am J Physiol Endocrinol Metab 296: E238-E243, 2009. First published October 28, 2008; doi: 10.1152/ajpendo.90684.2008. The objective of the study was the comparison of anti-Mullerian hormone (AMH) levels among obese or overweight and normal-weight women with the four different polycystic ovary syndrome (PCOS) phenotypes and healthy control subjects. AMH levels were evaluated in four age- and body mass index (BMI)-matched groups of 25 normal-weight and 25 obese or overweight women each, belonging to the four main subsets of the syndrome resulting from combinations of the three diagnostic criteria [group 1: oligo- and/or anovulation (ANOV), hyperandrogenemia (HA), and polycystic ovaries (PCO) on ultrasonographic evaluation; group 2: ANOV and HA; group 3: HA and PCO, group 4: ANOV and PCO], and in 50 (25 obese or overweight and 25 normal weight) age- and BMI-matched healthy control subjects. Age, BMI, waist circumference, FSH, LH, prolactin, testosterone, Delta(4)-androstenedione, dehydroepiandrosterone-sulfate, 17 alpha-OH-progesterone, fasting insulin, glucose, AMH, free androgen index, and homeostasis model assessment for insulin resistance index were analyzed. AMH levels were significantly higher in PCOS groups 1 and 2 compared with groups 3 and 4 and the control group and higher in PCOS groups 3 and 4 compared with the control group. AMH levels were significantly increased in normal-weight compared with obese and overweight women. AMH concentrations were independently predicted, in order of significance, by LH and testosterone levels, BMI (negatively), and the total number of follicles 2-9 mm in diameter. The differences in circulating AMH levels between the main phenotypic groups of PCOS women appear to reflect the severity of the syndrome, but are negatively affected by obesity. Increased LH levels might be the most significant independent link between PCOS-associated disorders of ovulation and the observed increase in circulating AMH concentration.