河南地区20~34岁育龄女性血清抗苗勒管激素参考区间的建立

Establishing reference intervals of serum anti-Müllerian hormone in women of childbearing age (20-34 years old) in Henan area

目的分析河南地区20~34岁不同年龄段育龄女性血清抗苗勒管激素(AMH)水平,建立其医学参考区间。方法纳入2017年1—6月前往河南地区13个项目点做孕前优生和婚前检查的健康育龄女性620名,按年龄分为3组:20~24岁组210名、25~29岁组207名、30~34岁组203名,检测血清AMH水平,用Spearman相关系数评估血清AMH水平与年龄之间的相关性,用Kruskal-WallisH检验比较不同年龄组的血清AMH水平;用Wilcoxon秩和检验进行两两间比较;用百分位数法(P2.5,P97.5)建立育龄女性总体及不同年龄段的血清AMH医学参考区间。结果育龄女性血清AMH与年龄的相关系数为-0.17(P<0.001)。3个不同年龄组的血清AMH水平频数总体分布差异有统计学意义(H=21.978,P<0.05),其中,20~24岁组与30~34岁组比较,血清AMH水平频数总体分布差异有统计学意义(Z=4.292,P<0.05),25~29岁组与30~34岁组比较,血清AMH水平频数总体分布差异有统计学意义(Z=3.803,P<0.05)。620例血清AMH参考范围为0.281~9.693 μg/L;20~24、25~29、30~34岁血清AMH参考区间分别为0.524~10.760、0.229~9.200、0.115~8.200 μg/L。结论育龄女性血清AMH水平随着年龄增长而降低,本研究首次建立了河南地区20~34岁育龄女性血清AMH参考区间。

Objective To analyze the serum anti-Müllerian hormone(AMH)levels in women of childbearing age in different age groups in Henan,and establish the medical reference intervals based on measurement results from this population.Methods From January to June 2017,620 healthy women of childbearing age(20-34 years old),who underwent pre-pregnancy eugenics and pre-marital checkups in 13 project sites in Henan,were included in this study.Participants were divided into 3 age groups:20-24 years group(n=210),25-29 years group(n=207),and 30-34 years group(n=203).Spearman correlation coefficient was used to evaluate the correlation between serum AMH level and age;Kruskal-Wallis H test was used to compare the serum AMH levels of different age groups;Wilcoxon test was used for comparison between pairs;the percentile method(P2.5,P97.5)was used to establish medical reference interval of serum AMH in women of childbearing age for the whole population and different age groups,respectively.Results The correlation coefficient between serum AMH and age in women of childbearing age(20-34 years old)is-0.17(P<0.001).There was a statistically significant difference in the overall frequency distribution of serum AMH levels among the three different age groups(H=21.978,P<0.05).Among them,there is a statistically significant difference between the 20-24 years group and the 30-34 years group(Z=4.292,P<0.05).There is a statistically significant difference between the 25-29 years group and the 30-34 years group(Z=3.803,P<0.05).The reference range of serum AMH is 0.281-9.693μg/L in this cohort;the reference range of serum AMH is 0.524-10.760,0.229-9.200,0.115-8.200μg/L for women of childbearing age at 20-24,25-29 and 30-34 years,respectively.Conclusion The serum AMH level of women of childbearing age(20-34 years old)decreases with age.It is of great significance to establish the serum AMH reference interval for women of childbearing age in different age groups in Henan.