Abstract
BackgroundAnti-Mullerian Hormone (AMH) has an important role in the pathophysiological process of polycystic ovary syndrome (PCOS) by regulating follicular development and is closely related to the severity of PCOS. Previous studies have suggested that AMH levels in PCOS is related to hyperandrogenemia levels and are affected by obesity and insulin resistance. however, the exact relationship between AMH levels and obesity and insulin resistance remains unclear. We aimed to elucidate the relationship between insulin resistance and obesity and serum AMH levels in women with PCOS. MethodsWe conducted a retrospective study of 220 women with PCOS who had undergone an assortment of physical, endocrine, and metabolic assessments. AMH levels and various other indicators of PCOS in patients with different body mass indices (BMI) and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) levels were compared. Independent sample t-tests were performed to compare two groups. Pearson correlation analysis was performed to study the correlation between AMH and age, obesity, IR, and other indicators of PCOS, and multiple linear regression analysis was performed to determine the factors influencing AMH. Bilateral tests were performed for all statistical tests. The data were analysed using SPSS v25.0. Statistical significance was defined as a two-sided P-value of less than 0.05.ResultsWe found that >50% of patients with PCOS had insulin resistance, obesity, hyperandrogenemia, and abnormal glucose tolerance. AMH, testosterone (T), and HOMA-IR levels were affected by age, and older participants had lower AMH, HOMA-IR, and androgen levels (P < 0.05). Glycated hemoglobin levels were higher and AMH, luteinizing hormone (LH)/follicle-stimulating hormone (FSH), and LH levels were lower in non-obese individuals than in obese individuals (both P < 0.05). Participants in the non-insulin resistant (IR; NIR) group were older than those in the IR group (P < 0.05). AMH, LH, LH/FSH, and T levels in the IR group were significantly higher than those in the NIR group (P < 0.05). AMH levels were positively correlated with LH, LH/FSH, T, fasting insulin (FINS), and HOMA-IR levels as well as the free androgen index and negatively correlated with age, BMI, and sex hormone binding globulin levels (P < 0.05). Through multiple linear regression, we found that AMH levels could be explained by T, LH/FSH, FINS, sex hormone binding globulin, LH levels, and BMI.ConclusionsSerum AMH levels were closely related to metabolic abnormalities in PCOS. In patients with PCOS, AMH levels were positively correlated with HOMA-IR levels and negatively correlated with BMI. Thus, AMH combined with BMI and HOMA-IR levels could help determine the severity of PCOS.
The Relationship Between Insulin Resistance and Obesity and Serum Anti-mullerian Hormone Level in Chinese Women With Polycystic Ovary Syndrome: A Case-control Study.
