Differentiation between polycystic ovary syndrome and polycystic ovarian morphology by means of an anti-Müllerian hormone cutoff value

Abstract

Background/AimsAlthough increased serum anti-Müllerian hormone (AMH) level has been suggested to be a surrogate marker of polycystic ovarian morphology (PCOM), its association with polycystic ovary syndrome (PCOS) is controversial, and its diagnostic value has not been determined. We aimed to observe the relationship between the AMH level and PCOS phenotypes and to determine the optimal cutoff value of AMH for the diagnosis of PCOS in young Korean women.MethodsWe recruited 207 women with PCOS (120 with PCOM and 87 without PCOM) and 220 regular cycling women with normoandrogenemia (100 with PCOM and 120 without PCOM). Subjects underwent testing at a single outpatient visit. Serum AMH level was measured.ResultsWomen with PCOS had higher serum AMH levels than did regular cycling women with normoandrogenemia (p < 0.05). Women with PCOM had higher serum AMH levels than women without PCOM, regardless of PCOS status (p < 0.05). The optimal AMH cutoff value for the diagnosis of PCOS was 10.0 ng/mL (71% sensitivity, 93% specificity). Serum AMH was an independent determinant of total testosterone after adjustment for age, body mass index, and the number of menses/year (β = 0.31, p < 0.01). An association between AMH and hyperandrogenism was only observed in women with PCOS, and it was independent of the presence of PCOM.ConclusionThe serum AMH level can be useful for the diagnosis of PCOS at any age less than 40 years, and the optimal cutoff value for the diagnosis of PCOS identified in this study of young Korean women was 10.0 ng/mL.

Using simple clinical measures to predict insulin resistance or hyperglycemia in girls with polycystic ovarian syndrome

“…19 Song et al also suggested TG:HDL to be a strong indicator of IR in young women with PCOS, when compared to OGTT models. 20 A TG and glucose index (TyG) also correlated well with GIR, and was found to work well in a pediatric obese population of youth. 18,21 We previously developed and validated a surrogate estimate of insulin sensitivity (e-IS) against GIR, in adolescents of varied BMI and with and without diabetes.…”

“…In a PCOS adult cohort, TG alone was identified as an effective marker in identifying IR, tightly correlating to HOMA‐IR . Song et al also suggested TG:HDL to be a strong indicator of IR in young women with PCOS, when compared to OGTT models . A TG and glucose index (TyG) also correlated well with GIR, and was found to work well in a pediatric obese population of youth .…”

Simplified 4‐item criteria for polycystic ovary syndrome: A bridge too far?

“…The attrition was largely due to a lack of willingness of the women to (i) come on another day for the scan and blood sampling, (ii) undergo a transvaginal ultrasound scan due to perceived discomfort or the women are virgo intacta and (iii) unable to reach them in a follow-up call. A further 49 women were then excluded as they were previously diagnosed as PCOS (n = 15), unable to tolerate transvaginal vaginal scans (iv), had persistent cysts >10 mm in either ovary on repeated Days 2-6 transvaginal ultrasound scans (21), had hyperprolactinaemia (4), had oestradiol below detection limit (4), or raised FSH (1).…”

“…16 It would be advantageous if AMH can replace the use of transvaginal ultrasound given the complexity, cost, inter-observer variation involved in the determination of AFC and OV. 6,17,18 The strong correlation that has been reported between PCOS and AMH by a multitude of studies, [19][20][21] has even lead to the view that AMH alone, may be a suitable as a single biomarker for PCOS. Nevertheless, there is a lack of studies examining the performance of various proposed criteria compared to the Rotterdam 2003 criteria.…”

Improving the accuracy and efficacy of diagnosing polycystic ovary syndrome by integrating metabolomics with clinical characteristics: study protocol for a randomized controlled trial

“…This difference might partly be related to epigenetic and environmental influences. Moreover, the free androgen index [34], serum AMH level [35][36][37][38], PPARGC1A (a leukocyte methylation promoter) [39], and some other indices were also found to be potential biomarkers for predicting PCOS and classifying its phenotypes. Although there have been many efforts to address the predicament surrounding the diagnosis of PCOS, the precise classification criteria have yet to be developed.…”