AMH in combination with SHBG for the diagnosis of polycystic ovary syndrome
AMH in combination with SHBG for the diagnosis of polycystic ovary syndrome
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DOI：
10.1080/01443615.2019.1587604
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发表时间：
2019-06-04
影响因子：
1.3
通讯作者：
Torres, Alberto M.
中科院分区：
文献类型：
--
作者：
Calzada, Mireya;Lopez, Natividad;Torres, Alberto M.
血清抗苗勒氏管激素（AMH）水平可用于诊断多囊卵巢综合征（PCOS）。我们评估了女性的荷尔蒙状态以诊断多囊卵巢综合症。共有 77 名 PCOS 女性和 106 名健康女性参加了这项研究。测量血清 AMH、促性腺激素 [黄体生成素 (LH) 和卵泡刺激素 (FSH)]、雌二醇、睾酮（总睾酮和游离睾酮）、4-雄烯二酮 (ANDST)、硫酸脱氢表雄酮、性激素结合球蛋白 (SHBG)、催乳素、促甲状腺激素和胰岛素水平 在所有登记的女性中。我们的数据显示，PCOS 组的胰岛素、LH、睾酮、ANDST 和 AHM 水平显着较高，而 FSH 和 SHBG 水平在 PCOS 组中较低。在受试者操作特征分析中，AMH 与 SHBG 组合显示出较高的 PCOS 诊断曲线下面积 (AUC)，AUC 为 0.843，特异性为 81.1%，敏感性为 72.7%。我们的结果表明，血清 AMH 和 SHBG 水平的组合可以用作 PCOS 的诊断生物标志物。影响声明 关于这个主题已有哪些知识？患有多囊卵巢综合症的女性患高血压的风险增加，葡萄糖代谢改变，并且可能增加终生患心血管疾病的风险。 PCOS 的诊断标准尚未达成共识。这导致许多 PCOS 患者未被诊断出来。众所周知，AMH 在 PCOS 的卵泡状态中发挥着重要作用，与正常排卵的女性相比，PCOS 女性的血清 AMH 水平显着升高。这就是为什么一些研究建议将 AMH 作为 PCOS 的诊断标准。这项研究的结果增加了什么？大量的流行病学数据表明较高的 AMH 水平与 PCOS 之间存在关联，但没有关于 AMH 水平与其他激素和 PCOS 的组合的信息。这是第一项调查 AMH 和 SHBG 与 PCOS 关联的研究。我们的结果表明，血清 AMH 和 SHBG 水平的组合可以作为筛查一般人群 PCOS 的有用且实用的测试。
Serum Anti-Mullerian hormone (AMH) level could be useful for the diagnosis of polycystic ovary syndrome (PCOS). We evaluated the hormonal status in women for the diagnosis of PCOS. A total of 77 PCOS women and 106 healthy women were enrolled in this study. Serum AMH, gonadotropins [luteinising hormone (LH) and follicle-stimulating hormone (FSH)], oestradiol, testosterone (total and free), 4-androstenedione (ANDST), dehydroepiandrosterone sulphate, sex hormone binding globulin (SHBG), prolactin, thyroid-stimulating hormone and insulin levels were measured in all enrolled women. Our data showed that insulin(,) LH, testosterone, ANDST and AHM levels were significantly higher in the PCOS group and FSH and SHBG levels were lower in the PCOS group. In Receiver operating characteristic analysis, the combination of AMH with SHBG showed higher area under curves (AUC) for PCOS diagnosis with an AUC of 0.843 and a specificity of 81.1% and a sensitivity of 72.7%. Our results suggest that a combination of serum AMH and SHBG levels could be used as a diagnostic biomarker of PCOS.Impact statement What is already known on this subject? Women with PCOS have an increased risk of hypertension, altered glucose metabolism and probably an increased lifetime risk of cardiovascular diseases. There is no consensus on the diagnostic criteria for PCOS. This leads to many patients with PCOS are being undiagnosed. It is known that AMH plays a role in the follicular status of PCOS and serum AMH level is increased significantly in women with PCOS compared with normo-ovulatory women. This is why several studies have suggested the inclusion of AMH as a diagnostic criterion in PCOS. What do the results of this study add? Extensive epidemiological data is available which demonstrates an association between higher AMH levels and PCOS, but there was no information available about the combination of AMH level with other hormones and PCOS. This is the first study that has investigated the association of AMH and SHBG, together, with PCOS. Our results suggest that serum AMH and SHBG level in combination could represent a useful and practical test to screen the general population for PCOS.