科研之友
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摘要
Objective: Functional androgenization (FA) can be divided into five groups corresponding to the predominant organ pathology as recently shown by our group: functional cutaneous androgenization (FCA, skin) and FA syndrome (FAS) I (ovary, lean individual), II (adrenal gland), III (ovary, fat tissue, pancreas, and hyperinsulinemia), and IV (residual FA dysfunctions). Group-specific clusters are based on primary variables such as LH, testosterone, DHEAS, sex hormone-binding globulin (SHBG), body mass index (BMI), glucose, insulin, and enlarged polyfollicular ovaries. Because anti-Mullerian hormone (AMH) positively correlates with the antral follicle count, its relevance as an additional primary variable for classifying FA was investigated.
Design: In this study, 178 patients with FA were consecutively enrolled and classified into the five FA groups as described earlier and 30 women with regular menstrual cycles served as control. Methods: Primary variables and serum AMH were analyzed in the early follicular phase.
Results: FA patients showed significantly elevated AMH levels (11.1 +/- 6.7 ng/ml) versus control (3.0 +/- 2.0 ng/ml; P<.0001). AMH was significantly increased in groups FAS I (15.6 +/- 5.8 ng/ml) and FAS III (11.6 +/- 6.6 ng/ml) compared with groups FCA (7.0 +/- 3.8 ng/ml), FAS II (5.05 +/- 3.0 ng/ml), and FAS IV (6.9 +/- 4.6 ng/ml) and correlated positively (P<.0001) with LH (r=0.538) and testosterone (r=0.368). In regression and multivariate analyses, AMH was not dependent on SHBG, DHEAS, BMI, glucose, or insulin. In receiver operating characteristic analysis, 9.21 ng/ml AMH showed 90% specificity with 71.2% sensitivity for the diagnosis of the two ovarian FA groups, FAS I and III.
Conclusion: AMH confirms the novel stratification system and constitutes a useful primary variable in the algorithm of FA classification.
- 出版日期2011-8
