| Objective:To investigate the differences of serum AMH and other serum indexds in patients with hyperandrogenism polycystic ovary syndrome(PCOS)and non-hyperandrogenism,and to evaluate the clinical value of AMH in the diagnosis and treatment of hyperandrogenism PCOS.Methods:A total of 60 PCOS patients were selected from the outpatient department of reproductive center of our hospital from February 2018 to February 2019.Patients' age,body mass index(BMI)and antral follicle count(AFC)were recorded.After an overnight fasting period of 10 hours,the elbow venous blood was taken to measure fasting blood glucose(FG)and fasting insulin(FINS).Serum AMH,LH(luteinizing hormone),FSH(follicle-stimulating hormone)and T(testosterone)were detected at the2 nd to 4th day of menstrual cycle or withdrawal bleeding or,at the early follicular phase under ultrasonic monitoring.According to the clinical or(and)biochemical hyperandrogenemia,the patients were divided into hyperandrogenism group and Non-hyperandrogenism group,Each group had 30 patients.All PCOS patients were treated with da-35 orally for 3cycles starting from the 3th day of menstrual cycle or withdrawalbleeding.Patients with abnormal insulin levels or obesity were also treated with metformin,and all patients were instructed to control their weight.BMI,AFC,serum AMH,LH,FSH,T,FG and FINS were recorded again after discontinuation.To compare the differences of general data and serum indexes between the two groups before and after treatment,Data were collected and statistically analyzed using SPSS 22.0statistical software.Results:1.Before treatment,general data and serum indexes of PCOS patients in hyperandrogenism group and non-hyperandrogenism group were compared: there were no statistical differences in age,BMI and AFC between the two groups(P > 0.05);The PCOS patients in the hyperandrogenism group had higher hairiness and acne scores than those in the non-hyperandrogenism group,and the difference was statistically significant(P < 0.05).Serum AMH and T values of PCOS patients in hyperandrogenism group were significantly higher than those in non-hyperandrogenism group(P < 0.05).The LH/FSH and FINS values of PCOS patients in the hyperandrogenism group were not significantly increased compared with those in the non-hyperandrogenism group,and the difference was not statistically significant(P > 0.05).2.General data and serological indexes of PCOS patients before and after treatment were compared: BMI of PCOS patients after treatmentwas lower than that before treatment,and scores of hairy and acne were lower than that before treatment,but the difference was not statistically significant(P>0.05).AFC decreased compared with that before treatment,and the difference was statistically significant(P < 0.05).LH/FSH,T,AMH and FINS all decreased significantly compared to that before treatment,and the difference was statistically significant(P < 0.05).FG had no significant change before treatment,and the difference was not statistically significant(P > 0.05).3.General data and serological indexes of PCOS patients before and after treatment in hyperandrogenism group and non-hyperandrogenism group were compared within the group.After treatment,BMI of PCOS patients in hyperandrogenism group decreased compared with that before treatment,but the difference was not statistically significant(P >0.05).AFC was lower than before treatment,and the score of hairy and acne was lower than before treatment,the difference was statistically significant(P<0.05).LH/FSH,T,AMH and FINS decreased significantly compared to that before treatment,and the difference was statistically significant(P < 0.05).FG value was not significantly lower than that before treatment,and the difference was not statistically significant(P>0.05).After treatment,BMI and AFC of PCOS patients in the non-hyperandrogenism group decreased compared with that before treatment,and their hairy and acne scores decreased compared with thatbefore treatment,but the differences were not statistically significant(P >0.05).LH/FSH value was significantly lower than that before treatment,and the difference was statistically significant(P < 0.05).The values of AMH,T,FG and FINS decreased after treatment,but the difference was not statistically significant(P > 0.05).4.The difference values of PCOS patients before and after treatment were compared between the two groups: the difference values of BMI decline of PCOS patients before and after treatment in the hyperandrogenism group and those in the non-hyperandrogenism group showed no statistical significance(P>0.05).AFC,hairy and acne scores were significantly lower than those of PCOS patients in non-hyperandrogenism group(P< 0.05).The average decrease range of PCOS patients' AMH in hyperandrogenism group was(4.59±6.11)ng/ml,and the average decrease range of PCOS patients in non-hyperandrogenism group was(0.87±3.23)ng/ml.The average decrease range of T value of PCOS patients in hyperandrogenism group(0.24±0.22)ng/ml,and the average decrease range of PCOS patients in non-hyperandrogenism group(0.04 ± 0.19)ng/ml.The difference between PCOS patients in the hyperandrogenism group and those in the non-hyperandrogenism group before and after treatment was significantly lower than that of PCOS patients in the hyperandrogenism group,and the difference was statistically significant(P < 0.05).There was no significant difference inLH/FSH and FG decline between the two groups before and after treatment(P > 0.05).Conclusion:1.The AMH value of hyperandrogenism PCOS patients is significantly higher than that of non-hyperandrogenism PCOS patients,and serum AMH is more suitable for the diagnosis of hyperandrogenism PCOS patients.2.After treatment,the serum AMH value of hyperandrogenism PCOS patients was significantly lower than that of non-hyperandrogenism PCOS patients,and serum AMH could be used to evaluate the therapeutic effect of hyperandrogenism PCOS patients.3.Serum AMH can be used as one of the criteria for the diagnosis and treatment of hyperandrogenism PCOS. |
PDF Full Text Request