Anti-Müllerian Hormone As a Diagnostic Marker in Egyptian Infertile Polycystic Ovary Syndrome Females: Correlations with Vitamin D, Total Testosterone, Dyslipidemia and Anthropometric Parameters

Overview

Journal J Med Biochem

Specialty Biochemistry

Date 2018 Dec 26

PMID 30584404

Citations 16

Authors

Engy Bakeer

Rasha Radwan

Ahmed El Mandoury

Abdullah Abd El Rahman

Mohamed Gad

Sahar Abd El Maksoud

Affiliations

Soon will be listed here.

Abstract

Background: Recent studies have highlighted the role of anti-Müllerian hormone (AMH) in numerous ovarian disorders. Polycystic Ovary Syndrome (PCOS) is one of the major causes of infertility in Egypt. Several reports have linked PCOS with vitamin D deficiency. This investigation illustrates the possibility of using serum AMH for PCOS diagnosis in infertile Egyptian females, determines the variables affecting it and correlates it with serum 25(OH)D, testosterone, dyslipidemia and anthropometric parameters.

Methods: All parameters were assessed either with ELISA or colorimetrically in 53 infertile PCOS women and 17 age matched apparently healthy controls diagnosed according to Rotterdam consensus.

Results: Serum AMH, total testosterone, triacylglycerol (TG) levels and BMI were significantly higher in PCOS group compared to healthy controls (p=0.0239, p=0.0381, p=0.0457, and p=0.0067, respectively), while serum 25(OH)D levels and HDL-cholesterol (HDL-C) were significantly lower (p=0.0397 and p=0.0443, respectively). No significant correlation existed between AMH and 25(OH) D, BMI and dyslipidemia markers. AMH was found to have a significant negative correlation with age and a highly significant positive one with total testosterone in PCOS group (r=-0.303, p=0.027 and r=0.370, p=0.008, respectively). In the receiver operating characteristic curve of AMH, the cut-off value was 42.63 pmol/L with a specificity of 59% and a sensitivity of 82%. Multivariate regression analysis showed total testosterone to be the only determinant for AMH (β=0.381 and p=0.038).

Conclusions: There should be a future trend of using AMH as a diagnostic marker for PCOS in Egyptian females. The variation in serum AMH levels is determined by total testosterone.

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References

Blagojevic I, Eror T, Pelivanovic J, Jelic S, Kotur-Stevuljevic J, Ignjatovic S . Women with Polycystic Ovary Syndrome and Risk of Cardiovascular Disease. J Med Biochem. 2018; 36(3):259-269. PMC: 6287215. DOI: 10.1515/jomb-2017-0020. View

Dewailly D, Andersen C, Balen A, Broekmans F, Dilaver N, Fanchin R . The physiology and clinical utility of anti-Mullerian hormone in women. Hum Reprod Update. 2014; 20(3):370-85. DOI: 10.1093/humupd/dmt062. View

Dewailly D, Gronier H, Poncelet E, ROBIN G, Leroy M, Pigny P . Diagnosis of polycystic ovary syndrome (PCOS): revisiting the threshold values of follicle count on ultrasound and of the serum AMH level for the definition of polycystic ovaries. Hum Reprod. 2011; 26(11):3123-9. DOI: 10.1093/humrep/der297. View

. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004; 81(1):19-25. DOI: 10.1016/j.fertnstert.2003.10.004. View

Fukuyama N, Homma K, Wakana N, Kudo K, Suyama A, Ohazama H . Validation of the Friedewald Equation for Evaluation of Plasma LDL-Cholesterol. J Clin Biochem Nutr. 2008; 43(1):1-5. PMC: 2459246. DOI: 10.3164/jcbn.2008036. View

Maciel G, Baracat E, Benda J, Markham S, Hensinger K, Chang R . Stockpiling of transitional and classic primary follicles in ovaries of women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2004; 89(11):5321-7. DOI: 10.1210/jc.2004-0643. View

Cappy H, Giacobini P, Pigny P, Bruyneel A, Leroy-Billiard M, Dewailly D . Low vitamin D3 and high anti-Müllerian hormone serum levels in the polycystic ovary syndrome (PCOS): Is there a link?. Ann Endocrinol (Paris). 2016; 77(5):593-599. DOI: 10.1016/j.ando.2016.02.001. View

Kevenaar M, Meerasahib M, Kramer P, van de Lang-Born B, de Jong F, Groome N . Serum anti-mullerian hormone levels reflect the size of the primordial follicle pool in mice. Endocrinology. 2006; 147(7):3228-34. DOI: 10.1210/en.2005-1588. View

Dunaif A, Segal K, FUTTERWEIT W, Dobrjansky A . Profound peripheral insulin resistance, independent of obesity, in polycystic ovary syndrome. Diabetes. 1989; 38(9):1165-74. DOI: 10.2337/diab.38.9.1165. View

10.

Pearce K, Gleeson K, Tremellen K . Serum anti-Mullerian hormone production is not correlated with seasonal fluctuations of vitamin D status in ovulatory or PCOS women. Hum Reprod. 2015; 30(9):2171-7. DOI: 10.1093/humrep/dev167. View

11.

Zarnani A, Shahbazi M, Salek-Moghaddam A, Zareie M, Tavakoli M, Ghasemi J . Vitamin D3 receptor is expressed in the endometrium of cycling mice throughout the estrous cycle. Fertil Steril. 2009; 93(8):2738-43. DOI: 10.1016/j.fertnstert.2009.09.045. View

12.

Pigny P, Jonard S, Robert Y, Dewailly D . Serum anti-Mullerian hormone as a surrogate for antral follicle count for definition of the polycystic ovary syndrome. J Clin Endocrinol Metab. 2005; 91(3):941-5. DOI: 10.1210/jc.2005-2076. View

13.

Fauser B, Tarlatzis B, Rebar R, Legro R, Balen A, Lobo R . Consensus on women's health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril. 2011; 97(1):28-38.e25. DOI: 10.1016/j.fertnstert.2011.09.024. View

14.

Hahn S, Haselhorst U, Tan S, Quadbeck B, Schmidt M, Roesler S . Low serum 25-hydroxyvitamin D concentrations are associated with insulin resistance and obesity in women with polycystic ovary syndrome. Exp Clin Endocrinol Diabetes. 2006; 114(10):577-83. DOI: 10.1055/s-2006-948308. View

15.

Pirwany I, Fleming R, Greer I, Packard C, Sattar N . Lipids and lipoprotein subfractions in women with PCOS: relationship to metabolic and endocrine parameters. Clin Endocrinol (Oxf). 2001; 54(4):447-53. DOI: 10.1046/j.1365-2265.2001.01228.x. View

16.

Wild R . Dyslipidemia in PCOS. Steroids. 2011; 77(4):295-9. DOI: 10.1016/j.steroids.2011.12.002. View

17.

Perkins N, Schisterman E . The inconsistency of "optimal" cutpoints obtained using two criteria based on the receiver operating characteristic curve. Am J Epidemiol. 2006; 163(7):670-5. PMC: 1444894. DOI: 10.1093/aje/kwj063. View

18.

Brunzell J, Ayyobi A . Dyslipidemia in the metabolic syndrome and type 2 diabetes mellitus. Am J Med. 2003; 115 Suppl 8A:24S-28S. DOI: 10.1016/j.amjmed.2003.08.011. View

19.

Legro R . Obesity and PCOS: implications for diagnosis and treatment. Semin Reprod Med. 2012; 30(6):496-506. PMC: 3649566. DOI: 10.1055/s-0032-1328878. View

20.

Avila E, Diaz L, Halhali A, Larrea F . Regulation of 25-hydroxyvitamin D3 1alpha-hydroxylase, 1,25-dihydroxyvitamin D3 24-hydroxylase and vitamin D receptor gene expression by 8-bromo cyclic AMP in cultured human syncytiotrophoblast cells. J Steroid Biochem Mol Biol. 2004; 89-90(1-5):115-9. DOI: 10.1016/j.jsbmb.2004.03.090. View