Study The Correlation Between AMH And BMI,Metabolic Factors In Women With PCOS

Background and purposesPolycystic ovary syndrome(PCOS)is a common reproductive endocrine disorder,a systemic metabolic syndrome characterized by hyperandrogenism,chronic non-ovulation,infertility and metabolic disorders.The pathogenesis is unknown,the clinical manifestation is diversity and individual difference.PCOS affects 5-10%reproductive age women in the world.More than 50%of PCOS patients suffer from obesity,but the mechanism of obesity affects the ovarian function is not clear now.AMH,a glycoprotein synthesized by the granulosa cells and pre-antral ovarian follicles,is also a kind of transforming growth factor(TGF-?),which plays an important role in affecting the recruitment of initial follicles and causing follicles to stop developing.Serum AMH levels are affected by many factors,such as age,race,metabolic factors,etc.The purpose of this study was to compare the different serum AMH level in PCOS patients between normal BMI and abnormal BMI,and to analyze the correlation between AMH and a number of factors such as BMI,total follicle count,fasting blood glucose,fasting insulin(FG),LDL-C,FSH,HDL-C,PRL,E2.We want to provide theoretical support for clinical treatment by this study.Material and methodsSPSS software(Statistical Package for the Social,Sciences version 19.0)was used for statistical analyses.Baseline characteristics between the two groups(PCOS patients with normal BMI and with abnormal BMI)was tested by independent-samples T text.Each variable is presented as x +s.Spearman correlation analysis was used to study the correlation between serum AMH and total follicle number,,age,fasting blood glucose,HDL-C,LDL-C in patients with PCOS.In order to eliminate the confounding factors such as age,the partial correlation analysis was carried out.A stepwise linear multiple regression analysis was carried out when a significant bivariate correlation was found between serum AMH and metabolic factors.This retrospective study included 1231 infertile PCOS women who visited the Center of reproductive medicine,Shandong University between June 2013 and December 2013.PCOS defined by Diagnostic criteria of China published in 2011,oligomenorrhea,amenorrhea or metrorrhagia is prerequisite,at least one of the following two critetia:clinical manifestation of Hyperandrogen or Hyperandrogenemia,ovarian area over 10 ml or follicle number 12 or more for one ovary or more.Obesity is defined by Diagnostic criteria of Asia published in 2000:BMI ?25 is Obesity.Women were divided into obese group(n=522,BMI ?25)or non-obese group(n=708,BMI<25)according to their BMI.All patients underwent a physical examination by the same doctor and blood tests on day 2 to 5,no matter it was a spontaneous cycle or not.Results1.The results showed that the age(31.94±3.74 vs 31.07±3.46,p<0.05),total follicle count(31.90±9.40 vs 30.56±8.66,p<0.05),T(40.82±19.90 vs 35.39±16.61,p<0.05),fasting blood glucose(5.79±0.97 vs 5.47±0.66,p<0.05),fasting insulin(21.54±11.93 vs 10.98±5.43,p<0.05),TC(4.66±0.83 vs 4.37±0.75,p<0.05),TG(1.72± 1.23 vs 1.20±0.69,p<0.05),LDL-C(3.40±0.86 vs 2.87±0.77,p<0.05)in obese group were higher than those in non-obese group,while AMH (5.49±3.78 vs 6.32±4.04,p<0.05),FSH(5.77±1.40 vs 6.14±1.78,p<0.05),LH(8.99±5.29 vs 10.32±6.12,p<0.05),PRL(17.39±9.58 v s21.79±18.17,p<0.05),HDL-C(1.09±0.21 vs 1.29±0.30,p<0.05)was lower than that in non-obese group.2.Spearman correlation analysis shows that AMH is correlated with:total follicle count(r = 0.325;P<0.001 0.0001).LH(r = 0.337;P<0.001).T(r = 0.234;P<0.001))E2(r =0.214;P<0.001)?HDL-C(r= 0.57;P = 0.0001)?age(r =-0.083;P = 0.004)?BMI(r =-0.110;P<0.001)?FSH(r =-0.070;P = 0.014)?fasting insulin(r=-0.101;P<0.001)?TG(r=-0.095;P = 0.001)?ConclusionsThere was a correlation between AMH and BMI in PCOS patients,and the correlation is still exists after correcting the influence of age factors.The level of serum AMH is mainly related to the changes of gonadotropin and steroid hormone.