Potential Application of Anti-Müllerian Hormone in Polycystic Ovary Syndrome According to Chinese Classification Criteria:A Retrospective Analysis

摘要

Objective:Anti-Müllerian hormone(AMH)expression is elevated in patients with polycystic ovary syndrome(PCOS),however,its clinical significance is not clear.Owing to the strong correlation between AMH and polycystic ovarian morphology(PCOM),some studies believe that AMH alone can be used to diagnose PCOS.The aim of this study was to explore whether AMH can be used to diagnose PCOS and to differentiate the various PCOS subtypes.Methods:This was a retrospective study of 503 patients with PCOS.Patients were divided into eight subtypes based on the presence/absence of hyperandrogenemia(HA),insulin resistance(IR),or obesity(OB).The expression characteristics of AMH in each subtype were analyzed.Due to the small number of patients with subtypes 7 and 8,only patients with subtypes 1-6 were included in the analysis.Results:AMH showed a good positive correlation with PCOM(P=0.000)and negative correlations with OB(P=0.000)and IR(P=0.003).The free testosterone index showed no correlation with AMH(P=0.803).The percentages of patients with each subtype(excluding subtypes 7-8)and their respective AMH levels were as follows:Type 1(HA+NIR+OB)4.77% and 9.12 ng/mL;Type 2(HA+IR+NOB)20.68% and 10.34 ng/mL;Type 3(HA+NIR+NOB)23.66% and 9.47 ng/mL;Type 4(HA+IR+OB)30.82% and 8.32 ng/mL;Type 5(NHA+NIR+NOB)11.73% and 10.0 ng/mL;and Type 6(NHA+IR+NOB)6.16% and 9.76 ng/mL.The diagnostic rates of AMH(>8.09 ng/mL)and ultrasound for PCOM were 60.10% and 85.60% ,respectively,suggesting that AMH did not completely predict PCOM.Conclusions:High AMH levels can be used to evaluate the incidence trend of PCOS.However,due to clinical heterogeneity,accurately evaluating the severity of PCOS and identifying the subtype of PCOS in Chinese patients are difficult.Individualized treatment should be administered based on accurate clinical subtypes and other clinical characteristics.