Anti-Müllerian hormone levels reflect severity of PCOS but are negatively influenced by obesity: relationship with increased luteinizing hormone levels

Abstract

The objective of the study was the comparison of anti-Müllerian 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, 17alpha-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.

The relationship between serum anti-Müllerian hormone levels and the follicular arrest for women with polycystic ovary syndrome

“…Our observation that AMH was similar between ovulatory and anovulatory PCO women appears to be different from several previous studies [Diamanti-Kandarakis et al DOI: 10.3109/19396368.2014.973123 2009; Homburg et al 2013;Piouka et al 2009;Thomson et al 2009] which reported that AMH levels correlated with the severity of the symptoms of PCO, with apparently higher levels of AMH associated with menstrual irregularity and hyperandrogenism. A possible explanation for the observation in these previous reports is that AFC is an important confounding variable of the serum AMH result.…”

“…Some studies combined non-PCOS and PCOS women together [Eldar-Geva et al 2005;Piouka et al 2009] or combined different cohorts with different serum AMH levels , that may yield a biased association between AMH and androgen in these combined groups. However, using logistic regression in the PCO group, we found that LH and T appeared to be the two most important factors affecting ovulation, whereas AMH and AFC did not appear to predict anovulation.…”

Diagnosis of Polycystic Ovary Syndrome: AMH in combination with clinical symptoms

“…Whether there is an association between serum AMH levels and different anthropometric, metabolic, and endocrine parameters in patients with PCOS is controversial; age has been reported to be both negatively related [38,40] and not correlated [41] with AMH. We found a negative correlation between age and AMH.…”

Plasma plasminogen activator inhibitor-1 levels in the different phenotypes of the polycystic ovary syndrome

“…Plasma glucose, insulin, FSH, LH, PRL, androgens, 17α-OHP, TSH and FT4 concentrations were measured as previously described [17]. Plasma SHBG levels were determined with an immunoradiometric assay (SHBG Immunoradiometric assay test, Diagnostics Systems Laboratories, Webster, TX, USA).…”