Role of anti-Mullerian hormone and testosterone in follicular growth: a cross-sectional study
Role of anti-Mullerian hormone and testosterone in follicular growth: a cross-sectional study
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抗苗勒氏管激素和睾酮在卵泡生长中的作用：横断面研究
DOI：
10.1186/s12902-020-00569-6
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发表时间：
2020-07-08
影响因子：
2.7
通讯作者：
Feng, Chun
中科院分区：
文献类型：
--
作者：
Lv, Ping-Ping;Jin, Min;Feng, Chun
背景抗苗勒管激素（AMH）是目前公认的卵巢储备功能最好的血清标志物，而基础性激素是评价卵巢储备功能的经典指标。AMH和性激素之间的相互作用是复杂的，没有得到充分的解决。本研究以卵巢储备功能减退（DOR）和多囊卵巢综合征（PCOS）为卵巢储备功能的两个极端（分别为卵巢储备功能不足和过度），探讨AMH和性激素在卵泡发育中的作用。方法采用回顾性横断面调查方法。本研究纳入2016年4月至2019年3月在浙江大学第二医院进行AMH和基础性激素评估的患者。采用电化学发光法测定血清AMH和性激素水平。采用逐步线性回归和二元Logistic回归分析AMH水平的预测因素，探讨DOR和PCOS的相关因素。结果年龄、卵泡刺激素（FSH）是AMH的主要负相关因素，促黄体生成素（LH）、睾酮（T）是AMH的主要正相关因素。DOR组年龄、FSH、E2升高，T降低，PCOS组LH、T升高。二元Logistic回归分析发现，年龄、体重、FSH、E-2和T是独立预测DOR可能性的重要因素，年龄、体重指数（BMI）、AMH、LH和T预测PCOS的可能性。结论年龄、FSH和T是AMH水平的主要影响因素，T与DOR和PCOS均相关。DOR和PCOS分别表现为AMH不足和AMH过多，提示总睾酮与AMH密切相关，在卵泡发育中起重要作用。在控制性超促排卵过程中应注意睾酮水平的变化。
Background Anti-Mullerian hormone (AMH) is now considered the best serum biomarker of ovarian reserve, while basal sex hormones are classic markers used for assessing ovarian reserve. The interaction between AMH and sex hormones are complicated and not sufficiently addressed. In this study, we took diminished ovarian reserve (DOR) and polycystic ovarian syndrome (PCOS) as two extremes of ovarian reserve (deficient and excessive respectively) to investigate the role of AMH and sex hormones in follicular growth. Methods A retrospective cross-sectional survey was performed. The patients assessed AMH and basal sex hormones in the Second Hospital of Zhejiang University from April 2016 to March 2019 were involved in this study. Serum AMH and sex hormone concentrations were tested with electrochemiluminescence method. Stepwise linear regression and binary logistic regression was used to determine the predictors of AMH level and to explore the involved factors determining DOR and PCOS. Results In the present study, we found that age and follicle-stimulating hormone (FSH) were main negative correlation factors, and luteinizing hormone (LH) and testosterone (T) were main positive factors of AMH. In DOR group, age, FSH and estradiol (E-2) increased and T decreased, while in PCOS group, LH and T increased. Binary logistic regression found that age, weight, FSH, E-2, and T were the significant factors which independently predicted the likelihood of DOR, and that age, body mass index (BMI), AMH, LH, and T predicted the likelihood of PCOS. Conclusions Our study demonstrated that age, FSH, and T were factors that most closely correlated with AMH level, and T was involved in both DOR and PCOS. Since DOR and PCOS are manifested with insufficient AMH and excessive AMH respectively, it is suggested that total testosterone correlated with AMH closely and plays an important role in follicular growth. More attention should be given to testosterone level during controlled ovarian hyperstimulation (COH) process.