Differences of the association of anti-Müllerian hormone with clinical or biochemical characteristics between women with and without polycystic ovary syndrome

Abstract

POLYCYSTIC OVARY SYNDROME (PCOS) is one of the most common endocrinological problems in women. In addition to chronic oligo-anovulation, the main features of the PCOS include elevated levels of circulating androgens and/or clinical hyperandrogenism, polycystic ovary morphology, altered gonadotropin secretion, insulin resistance and/or compensatory hyperinsulinemia often associated with obesity [1]. Women affected by PCOS also show a higher risk of type 2 diabetes, dyslipidemia, hypertension and cardiovascular diseases [2][3][4].Differences of the association of anti-Müllerian hormone with clinical or biochemical characteristics between women with and without polycystic ovary syndrome Abstract. The aim of the present study was to compare the associations of anti-Müllerian hormone (AMH) with clinical or biochemical characteristics between women with and without polycystic ovary syndrome (PCOS). We also explored the optimal cutoff point of AMH to diagnose PCOS. A cross-sectional study was performed in 87 women diagnosed with PCOS and 53 healthy control subjects. Body mass index (BMI), indices of insulin resistance, metabolic syndrome-related variables, reproductive hormones and serum AMH were measured in all subjects. We conducted receiver operating characteristic (ROC) curve analysis to determine the cutoff of AMH for diagnosis of PCOS. Serum AMH levels were significantly (p <0.001) higher in women with PCOS after adjustment for age and BMI. AMH levels were not significantly related with obesity, indices of insulin resistance, and metabolic syndrome-related variables in both PCOS and control groups. In the control group, AMH levels showed positive correlations with total testosterone (p <0.001), free testosterone (p=0.024), and adiponectin (p=0.002), and showed negative correlations with age (p=0.010) and estradiol (E2) (p=0.012). However, only total (p=0.044) and free testosterone (p=0.012) levels showed significant positive correlations with serum AMH level in PCOS group. ROC curve analysis showed a cutoff point for AMH of 7.82 ng/mL (sensitivity 75.9%, specificity 86.8%) for diagnosis of PCOS. Differences of the association of AMH with clinical or biochemical characteristics between women with PCOS and control groups were observed. This might contribute to the pathogenesis of PCOS, although further investigation is necessary to elucidate the detailed mechanism.

Obesity adversely affects serum anti-müllerian hormone (AMH) levels in Caucasian women

“…However, data examining the effect on BMI on AMH levels among women with PCOS have been conflicting. Woo et al and Cassar et al did not find any association between AMH and BMI or obesity, respectively, among women with or without PCOS [36,37]. On the other hand, Piouka et al showed that both overweight and obese women with PCOS had lower serum AMH levels when compared to lean women with PCOS [38].…”

“…Despite similar age and diagnosis, the discrepancy between these two studies is intriguing. However, the participants in the study by Woo et al were Asians, and hence, overweight and obesity were defined differently (BMI >23 kg/m 2 ), and the race of the participants in Cassar et al (a study from Australia) and Piouka et al (a study from Greece with potentially Mediterranean participants) studies were not stated [36][37][38]. Furthermore, our data analysis utilized a model incorporating age, BMI, smoking, and the presence or absence of PCOS, in which BMI still correlated negatively with AMH among C women (β=0.17, p=0.01) but not among women from other races.…”

Anti‐Müllerian hormone as a marker of ovarian reserve: What have we learned, and what should we know?

“…Therefore, serum AMH levels increase by 2-3-fold in women with early stage PCOS compared with normal controls. The sensitivity of serum AMH for diagnosis of PCOS ranges from 64 to 99 % [60][61][62][63][64][65][66][67][68]. The wide range of sensitivities among studies is likely due to variations in diagnostic criteria and in the age of the patient population.…”

Is anti-Mullerian hormone an indicator of potential polycystic ovary syndrome in prepubertal girls with simple obesity?

“…However, there are studies that do not support the relationships between AMH and BMI. In a study of adult women with PCOS, PCOS and control groups did not differ significantly regarding BMI and AMH assessments 24 . In our study, no significant difference in AMH levels was observed in group 1 compared to group 2, group 3 or the control group.…”

“…According to the authors, these findings suggest that serum AMH level could be a marker in differential diagnosis between late-onset congenital adrenal hyperplasia and PCOS which includes three main criteria. In a study of patients with adult PCOS, free testosterone, total testosterone and DHEA-S levels were higher compared to the control group, and a positive correlation was determined between AMH levels and free and total testosterone levels in the PCOS group 18 .…”