Age-related aspects of estimation of AMH levels in polycystic ovary syndrome
Objective. To determine anti-Müllerian hormone (AMH) threshold levels significant for the diagnosis of polycystic ovary syndrome (PCOS), by examining the age-related features of AMH secretion.Naidukova A.A., Kaprina E.K., Ivanets T.Yu., Chernukha G.E.
Subject and methods. The investigation enrolled 546 reproductive-aged women: 272 with PCOS (mean age 24.9±4.5 years; mean body mass index (BMI) 24.2±5.6 kg/m2) and 274 (mean age 25.0±4.1 years; mean BMI 25.2±4.7 kg/m2) without reproductive dysfunction and hyperandrogenism. Complex clinical laboratory examination, including pelvic ultrasound, was conducted; the androgenic profile, serum AMH, luteinizing hormone, follicle-stimulating hormone, prolactin, and thyroid-stimulating hormone levels were estimated. ROC-analysis was used to develop normative values.
Results. The mean AMH values did not substantially change in PCOS patients aged 18 to 34 years; these decreased from 5.1±1.7 to 2.6±1.0 ng/ml (p < 0.05). A negative correlation was found between AMH levels and age (r = -0.542, p < 0.005). The AMH threshold level for PCOS, which was determined disregarding the patients’ age, was 5.8 ng/ml (AUC 0.98, 94% sensitivity, 93%, specificity, 95% confidence interval (CI)). The age stratification of patients showed the low specificity of this indicator in the 20–24-year-old age subgroups and in 18–19-year-olds in particular.
Conclusion. The assessment of the specific features of AMH secretion in patients with PCOS versus healthy women gives grounds to develop AMH threshold values in different age groups. The determination of the age threshold values of AMH can considerably increase the sensitivity and specificity of the technique and consequently improve the accuracy of PCOS diagnosis.
Keywords
polycystic ovary syndrome
age
anti-Müllerian hormone
threshold level
Supplementary Materials
- Picture 1. Mean AMH levels in different age categories.
- Picture 2. AMH elevations frequency in age subgroups.
- Table. The diagnostic potential of AMH threshold levels based on ROC-analyses.
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Received 02.11.2016
Accepted 11.11.2016
About the Authors
Naydukova Alina A., graduate student of Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia.117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +79166750097. E-mail: aleeshka@mail.ru
Kaprina Elena K., graduate student of Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +79161294118
Ivanets Tatiana Yu., PhD, head of research and diagnostic laboratory, Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74955314444. E-mail: t-ivanets@oparina4.ru
Chernukha Galina E., MD, department of gynecological endocrinology, Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +79859996000. E-mail: c-galina1@yandex.ru
For citations: Naidukova A.A., Kaprina E.K., Ivanets T.Yu., Chernukha G.E. Age-related aspects of estimation of AMH levels in polycystic ovary syndrome. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (3): 95-100. (in Russian)
http://dx.doi.org/10.18565/aig.2017.3.95-100
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