多囊卵巢综合征不同表型的血清抗苗勒管激素水平特征的分析

doi:10.3969/j.issn.1006-7795.2016.04.006

首都医科大学学报 ›› 2016, Vol. 37 ›› Issue (4): 444-448.doi: 10.3969/j.issn.1006-7795.2016.04.006

多囊卵巢综合征不同表型的血清抗苗勒管激素水平特征的分析

王利娟¹, 阮祥燕¹, 崔亚美¹, 赵越¹, 杜娟¹, 李扬璐¹, 易迎春^1,2, Alfred O. Mueck^1,3

1. 首都医科大学附属北京妇产医院内分泌科, 北京 100026;
2. 江西省妇幼保健院生殖健康科, 南昌 330008;
3. 德国图宾根大学妇产医院绝经内分泌中心, 图宾根 D-72076, 德国

收稿日期:2016-06-15 出版日期:2016-08-21 发布日期:2016-07-18
通讯作者: 阮祥燕 E-mail:ruanxiangyan@163.com
基金资助:
北京市自然科学基金（Y161011），北京市卫生系统高层次卫生技术人才（学科带头人）（2014-2-016），首都医科大学附属北京妇产医院、北京妇幼保健院学科带头人项目（2013-1）。

Analysis of serum anti-Müllerian hormone levels in the main phenotypes of polycystic ovary syndrome

Wang Lijuan¹, Ruan Xiangyan¹, Cui Yamei¹, Zhao Yue¹, Du Juan¹, Li Yanglu¹, Yi Yingchun^1,2, Alfred O. Mueck^1,3

1. Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China;
2. Department of Reproductive Health, Jiangxi Maternal and Child Health Hospital, Nanchang 330008, China;
3. Section of Endocrinology and Menopause, Department of Women's Health, University of Tubingen, Tubingen D-72076, Germany

Received:2016-06-15 Online:2016-08-21 Published:2016-07-18
Supported by:
This study was supported by Natural Science Foundation of Beijing(Y161011);Beijing Municipality Health Technology High-level Talent(2014-2-016);Project of Discipline Leader,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing Maternal and Child Health Care Hospital(2013-1).

摘要/Abstract

摘要： 目的分析各型多囊卵巢综合征（polycystic ovary syndrome，PCOS）患者和对照组的血清抗苗勒管激素（serum anti-müllerian hormone，AMH）浓度及内分泌和代谢指标的特点，并评估AMH与这些指标的相关性。方法选取2016年1月至2016年5月间在首都医科大学附属北京妇产医院内分泌科就诊的PCOS患者174例为研究组，依据美国国立卫生院（National Institutes of Health，NIH）指南推荐的分型方法将其分为4组，组1卵巢多囊样改变[（polycystic ovary morphology，PCO）+稀发排卵或无排卵（oligo-anovulation，OA）+高雄激素血症（hyperandrogenism，HA）]45例；组2（PCO+OA）39例；组3（PCO+HA）42例；组4（OA+HA）48例。另选41例同期就诊的年龄及体质量匹配、基础体温双相的输卵管性不孕患者或正常体检者作为对照组。测量所有参与者的身高、体质量、腰围、臀围等一般情况，空腹抽血查AMH、性激素、血糖、胰岛素等。超声测量卵巢的长径、横径、前后径及每侧卵巢内的卵泡直径和数量。分析不同PCOS表型组及对照组的血清AMH质量浓度及内分泌和代谢指标特点。结果血清AMH质量浓度：组1（8.54±2.40）ng/mL > 组2（6.95±1.96）ng/mL > 组3（5.64±1.79）ng/mL > 组4（4.36±1.74）ng/mL > 对照组（2.55±1.15）ng/mL，组间差异有统计学意义（P<0.05）。血清AMH与PCOS患者的睾酮、卵巢体积和2～9 mm窦卵泡数呈正相关（P<0.05），与雌二醇呈负相关（P<0.05），与年龄、体质量指数、腰臀比、促黄体生成素、卵泡刺激素、空腹血糖、空腹胰岛素、胰岛素抵抗指数无相关性（P>0.05）。结论 PCOS患者血清AMH质量浓度较对照组显著增加，AMH在不同表型组间差异有统计学意义（P<0.05）。PCO是影响AMH浓度的最显著因素。血清AMH浓度与PCOS患者的睾酮浓度、卵巢体积和2～9 mm窦卵泡数正相关，与雌二醇水平负相关。

关键词: 多囊卵巢综合征, 分型, 抗苗勒管激素, 卵巢多囊样改变

Abstract: Objective To analyze the serum anti-Müllerian hormone (AMH) levels, endocrine and metabolic characteristics in the main phenotypes of polycystic ovary syndrome (PCOS) groups and the controls, and evaluate the correlation between the AMH and these indicators. Methods A total of 174 PCOS cases were divided into four groups according to Rotterdam criteria and NIH recommendations, as follows:Group 1[polycystic ovary morphology (PCO) +oligo-anovulation (OA) +hyperandrogenism (HA)], Group 2 (PCO+OA), Group 3 (PCO+HA) and Group 4 (OA+HA). AMH, endocrine and metabolic levels were measured in serum. Results Serum anti-müllerian hormone levels:Group 1 (8.54±2.40) ng/mL > Group 2 (6.95±1.96) ng/mL > Group 3 (5.64±1.79) ng/mL > Group 4 (4.36±1.74) ng/mL > Controls (2.55±1.15) ng/mL. Conclusion AMH levels were higher in PCOS cases than in controls, with differences comparing the phenotypes. AMH levels correlate best with PCO. AMH has a positive correlation with the testosterone (T), number of follicles 2-9 mm and ovarian volume, has a negative correlation with estradiol (E2).

Key words: polycystic ovary syndrome, phenotype, anti-Müllerian hormone, polycystic ovary morphology

中图分类号:

R711.75

王利娟, 阮祥燕, 崔亚美, 赵越, 杜娟, 李扬璐, 易迎春, Alfred O. Mueck. 多囊卵巢综合征不同表型的血清抗苗勒管激素水平特征的分析[J]. 首都医科大学学报, 2016, 37(4): 444-448.

Wang Lijuan, Ruan Xiangyan, Cui Yamei, Zhao Yue, Du Juan, Li Yanglu, Yi Yingchun, Alfred O. Mueck. Analysis of serum anti-Müllerian hormone levels in the main phenotypes of polycystic ovary syndrome[J]. Journal of Capital Medical University, 2016, 37(4): 444-448.

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多囊卵巢综合征不同表型的血清抗苗勒管激素水平特征的分析

Analysis of serum anti-Müllerian hormone levels in the main phenotypes of polycystic ovary syndrome

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