Anti-Mullerian hormone in the diagnosis of polycystic ovary syndrome: can morphologic description be replaced?
Anti-Mullerian hormone in the diagnosis of polycystic ovary syndrome: can morphologic description be replaced?
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DOI：
10.1093/humrep/des213
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发表时间：
2012-08-01
影响因子：
6.1
通讯作者：
Carlsen, Sven M.
中科院分区：
文献类型：
--
作者：
Eilertsen, Tina B.;Vanky, Eszter;Carlsen, Sven M.
抗苗勒管激素（AMH）水平能否代替形态学描述诊断多囊卵巢综合征（PCOS）？AMH与PCOS不同诊断标准的关系？AMH可替代多囊卵巢形态学（PCOM）诊断PCOS，AMH可替代窦卵泡计数（AFC）诊断PCOS。截止值为AMH研究到目前为止，显示了一个可以接受的特异性，但相当差的敏感性，留下了多达三分之一的PCOS women undiagnosed.We使用的数据从一个横截面，病例对照研究的妇女与以前的早产和他们的控制，即妇女与以前的足月分娩。262例患者中，符合鹿特丹标准（PCOS-R）的56例，符合雄激素过多PCOS协会（PCOS-AES）标准的44例。用AMH代替PCOM重新诊断PCOS-R和PCOS-AES。主要观察指标为PCOS、PCOM、多毛症、少乳症的患病率以及血清AMH和雄激素水平，当用AMH代替PCOM时，根据PCOS-R标准诊断PCOS的特异性和敏感性分别为97.1和94.6，根据PCOS-AES标准诊断PCOS的特异性和敏感性分别为97.2和95.5。AMH临界值为20 pmol/本研究由挪威中部地区卫生局和挪威科学大学合作资助，和技术作者没有兴趣披露。本研究注册为NCT 01355536。
Can anti-Mllerian hormone (AMH) level replace the morphologic description in the diagnosis of polycystic ovary syndrome (PCOS) and what is the relationship between AMH and different diagnostic criteria of PCOS?AMH may be a good substitute for polycystic ovarian morphology (PCOM) in diagnosing PCOS.AMH has been suggested as an alternative to antral follicle count (AFC) in diagnosing PCOS. Cut-off values for AMH studied so far show an acceptable specificity but a rather poor sensitivity, leaving up to one-third of PCOS women undiagnosed.We used data from a cross-sectional, casecontrol study on women with prior preterm birth and their controls, i.e. women with prior full-term birth. Among 262 women, 56 met the Rotterdam criteria (PCOS-R) and 44 the Androgen Excess-PCOS Society (PCOS-AES) criteria of PCOS.Fasting blood samples were collected, a transvaginal ultrasound investigation and a clinical examination were performed. PCOS-R and PCOS-AES were re-diagnosed by replacing PCOM with AMH. Main outcome measures were the prevalence of PCOS, PCOM, hirsutism, oligoamenorrhoea and serum levels of AMH and androgens.When replacing PCOM with AMH, the specificity and sensitivity for identifying PCOS were 97.1 and 94.6 according to the PCOS-R criteria and 97.2 and 95.5 according to the PCOS-AES criteria, respectively, at an AMH cut-off value of 20 pmol/l.The results need to be confirmed when international standards and methods for AMH measurements are established.AMH may be a good substitute for PCOM in diagnosing PCOS.This study was financed by the Cooperative of Central Norway Regional Health Authority and Norwegian University of Science and Technology. The authors have no interests to disclose.This study is registered at as NCT01355536.