| Objective: Polycystic ovary syndrome(PCOS)affects up to 20% of women of reproductive age.As a major cause of anovulatory infertility,PCOS brings huge health and economic burdens.Obesity is a state of excess body fat accumulation,which is closely related to PCOS.Abnormal accumulation of body fat is an important factor in causing metabolic abnormalities.Body fat accumulation can be described by body fat percentage(BFP).Anti-Müllerian hormone(AMH)is a surrogate marker for polycystic ovary and a biomarker for PCOS.Obesity states can modulate the biogenesis pathways of the substance,resulting in significantly lower AMH levels in women of high body weight than in women of normal body weight.However,the relationship between BFP and AMH in PCOS patients is still unclear.Whether BFP can affect AMH and how effective it is,has not been reported yet.Therefore,this study compared the differences of serum AMH and BFP in patients with or without PCOS,analyzed the possible relationship between AMH and BFP,and further explored the effect of BFP on PCOS.Methods: 1.A total of 377 Han women(including 118 control patients and 259 PCOS patients)between the ages of 25 to 40 who visited the Reproductive Medicine Center of Shengjing Hospital Affiliated to China Medical University from 2019 to 2021 were collected.2.Use the body composition analyzer to measure the body fat percentage of all enrolled patients;Chemiluminescence was used to detect the concentration of AMH;ELISA to detect the concentration of free testosterone and dehydroepiandrosterone;use the automatic immunoassay analyzer in the clinical laboratory of our hospital to measure all the samples,like estradiol,progesterone,total testosterone,luteinizing hormone,prolactin,follicle-stimulating hormone,thyrotropin,total cholesterol,high-density lipoprotein,low-density lipoprotein,triglycerides,fasting glucose and fasting insulin.3.According to the body mass index(BMI),the PCOS and the control group were divided into the lean group and the overweight/obesity group respectively,and then the patients with PCOS and the control group were divided into the normal insulin group and the hyperinsulinemic group according to the serum fasting insulin level.According to serum AMH levels,PCOS patients were further divided into high AMH group and normal AMH group.4.Statistical analysis: Pearson analysis be used to discuss the possible relationship between body fat percentage and AMH,univariate and multivariate regression analysis to discuss whether and how serum AMH levels were related to body fat percentage;receiver operating characteristic(ROC)curve analysis was used to test the utility of body fat percentage in the diagnosis of PCOS,and the effect of body fat percentage and AMH on the diagnosis of PCOS when combined analysis utility;logistic regression analysis to whether fat percentage affects the risk of PCOS and how well it affects the efficacy after adjusted the relevant variables.Results: 1.Regardless of overweight/obesity,the body fat percentage and other obesity indicators including waist-to-hip ratio,body fat mass,and visceral fat in the PCOS group were higher than those in the control group when there was no statistical difference in BMI.2.The AMH of overweight/obese control women was lower than that of normal weight control women,the AMH of overweight/obese PCOS women was lower than that of normal weight PCOS women,and the AMH of hyper-insulinemic PCOS patients was lower than that of normal insulin PCOS patients.3.The body fat percentage of PCOS patients with normal AMH was higher than that of control and PCOS patients with high AMH.4.There was a negative correlation between AMH and various obesity indicators in the PCOS group;there was no significant correlation in the control group as a whole,only in the normal insulin control group AMH was negatively correlated with obesity indicators.5.Decreased AMH was associated with increased body fat percentage in the linear model(β coefficient =-0.164;95% confidence interval,-0.292 to-0.036;P = 0.034).6.The AUC of AMH for predicting PCOS was 85.1%,the cutoff value was 5.63 ng/m L,the sensitivity was 78.3%,the specificity was 78.0%,the positive predictive value(PPV)was 88.7%,and the negative predictive value(NPV)was 62.1%.7.The AUC of body fat percentage in predicting PCOS was 70.5%,the cutoff value was 36.05%,the sensitivity was 65.3%,the specificity was 80.6%,the PPV was 88.1%,and the NPV was 51.4%.8.Combining AMH and body fat percentage into the multivariate model,the AUC increased to 91.1%,the sensitivity was 83.7%,the specificity was 84.0%,the PPV was 91.9%,the NPV was 70.1%.9.Multivariate logistic regression analysis showed that increased body fat percentage was associated with higher risk of PCOS(OR = 1.202;95% confidence interval,1.118-1.293,P < 0.001).Conclusion: Change of body fat percentage is one of the factors of AMH change in PCOS patients.Body fat percentage will have a negative effect on AMH in patients with PCOS;The combined analysis of AMH and body fat percentage has certain diagnostic value for PCOS. |
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