Do the Anti-Müllerian Hormone Levels of Adolescents with Polycystic Ovary Syndrome, Those Who Are at Risk for Developing Polycystic Ovary Syndrome, and Those Who Exhibit Isolated Oligomenorrhea Differ from Those of Adolescents with Normal Menstrual Cycles?

Abstract

Background/Aims: We aimed to investigate whether the anti-Müllerian hormone (AMH) levels in adolescents with polycystic ovary syndrome (PCOS), PCOS risk, and isolated oligomenorrhea (OM) were different than in adolescents with a normal/regular menstrual cycle (NMC). Methods: The diagnosis of PCOS was based on the 2012 Amsterdam [European Society of Human Reproduction and Embryology/American Society for Reproductive Medicine (ESHRE/ASRM)] criteria. The PCOS group consisted of cases meeting 3 diagnostic criteria (n = 21), and the PCOS risk group was the ‘at risk' group meeting 2 diagnostic criteria (n = 20). Cases with isolated OM that did not satisfy other PCOS diagnostic criteria made up the OM group (n = 21). Thirty adolescent girls with NMCs (21-45 days) were recruited in this study. Results: The AMH levels in the PCOS group were similar to those in the PCOS risk group but significantly higher than those in the OM and NMC groups. The AMH levels in the PCOS risk group were similar to those in the OM group and significantly higher than those in the NMC group. They were also significantly higher in the OM group compared to the NMC group. The specificity for PCOS and PCOS risk with a cutoff value of 7.25 ng/ml for AMH was 72.5% and the sensitivity was 58%. Conclusion: An AMH cutoff value of 7.25 ng/ml can be used for the diagnosis of PCOS in the adolescent period.

Anti-Müllerian Hormone in Obese Adolescent Girls With Polycystic Ovary Syndrome

“…Our cross-sectional observation of a significant difference in serum AMH concentrations between obese girls with PCOS vs. without PCOS supports and advances previous findings in the pediatric literature (15-20). However, most of the pediatric literature on AMH is in lean girls or combined non-obese and obese PCOS girls (16-20), without particular focus in obese girls.…”

“…However, most of the pediatric literature on AMH is in lean girls or combined non-obese and obese PCOS girls (16-20), without particular focus in obese girls. Our data show that obese girls with PCOS have ~50% higher serum AMH levels compared with obese girls without PCOS.…”

“…Our data show that obese girls with PCOS have ~50% higher serum AMH levels compared with obese girls without PCOS. Although the magnitude of difference in AMH concentrations between control and PCOS groups varies among various pediatric studies (ranging from 24-54%) (15-20), it should be noted that different selection criteria of the study populations/groups used (i.e., a wide range of age, BMI, and different combination of PCOS criterion or characteristics of the control group), and a variety of methods for measuring AMH may contribute to this variance.…”

“…A recent meta-analysis suggested a 4.7 ng/mL as an optimal AMH concentration for diagnosing PCOS, based mostly on adult studies (only one pediatric study was included), with AMH cutoff levels ranging between 2.8-8.4 ng/mL (8). Data with respect to the diagnostic utility of AMH in adolescents with PCOS particularly in obese adolescents are sparse (15-20). Therefore, the purpose of this study was: 1) to investigate AMH levels in obese adolescent girls with PCOS in comparison to obese girls without PCOS, 2) to assess the relationship of AMH to sex steroid hormone profile, adiposity measures and insulin resistance, a major metabolic component of PCOS, and 3) to examine the optimal AMH cutoff and the multivariable prediction model to predict PCOS in obese girls.…”

Longitudinal analyses of the steroid metabolome in obese PCOS girls with weight loss

“…Estrogens are transformed from androgens by aromatase. Experimental studies in animal models revealed that anti-Muellerian hormone (AMH), which is increased in PCOS (34), inhibits the FSH-dependent aromatase in granulosa cells (35). Studies in women with PCOS reported negative associations between AMH and estradiol concentrations (36).…”