青春期多囊卵巢综合征患者AMH与25(OH)D_(3)的关联性研究

Study on the relationship between anti-Müllerian hormone and 25(OH)D_(3) in adolescent patients with polycystic ovary syndrome

目的探讨青春期多囊卵巢综合征(PCOS)患者血清抗苗勒管激素(AMH)与25(OH)D_(3)水平的相关性。方法本研究选择在2019年1月-2020年12月在我院妇科门诊就诊的PCOS青春期女性79名,另选择同期体检的非PCOS健康对照85名。对所有受试者测量身高、体质量,计算体质量指数(BMI)。由诊治医生检查研究对象是否有痤疮、多毛以及月经情况。抽取静脉血检测黄体生成素、卵泡刺激素、总睾酮、硫酸脱氢表雄酮、抗苗勒管激素和25(OH)D_(3),将25(OH)D_(3)分为不足[25(OH)D_(3)<30 ng/mL]和缺乏[25(OH)D_(3)<20 ng/mL]2组,对数据进行比较分析。结果与健康对照组比较,PCOS组更容易发生月经稀发/闭经,其痤疮发生率较高(P值均<0.05)。体质量指数、AMH值、总睾酮和硫酸脱氢表雄酮的体内检出水平在PCOS组较高,而25(OH)D_(3)在PCOS组较低(P值均<0.05)。PCOS组的AMH与BMI和总睾酮呈正相关关系,与25(OH)D_(3)呈负相关关系(P值均<0.05)。25(OH)D_(3)缺乏组的AMH水平高于25(OH)D_(3)不足组,对照组和PCOS组的25(OH)D_(3)缺乏组的AMH水平均高于25(OH)D_(3)不足组,两两比较其差异有统计学意义(P值均<0.05)。健康对照组的25(OH)D_(3)缺乏率为67.1%(57/85),而PCOS组的25(OH)D_(3)缺乏率为96.2%(76/79),2组比较其差异有统计学意义(χ^(2)=22.68,P<0.001)。结论青春期多囊卵巢综合征患者体内25(OH)D_(3)水平与AMH水平显著相关。AMH和25(OH)D_(3)可用于评估青春期PCOS发病风险的替代指标。

Objective To explore the correlation between serum anti-Müllerian hormone(AMH) and 25(OH)D_(3)levels in adolescent patients with polycystic ovary syndrome(PCOS). Methods Seventy-nine adolescent girls with PCOS and 85 non-PCOS healthy controls who walked in the gynecological clinic of our hospital from January 2019 to December 2020 were selected. Height, weight were measured and body mass index(BMI) was calculated.Hirsutism, acne and menstruation were evaluated by doctors on all subjects. Venous blood was drawn to detect levels of luteinizing hormone, follicle stimulating hormone, total testosterone, dehydroepiandrosterone sulfate, AMH and 25(OH)D_(3), 25(OH)D_(3)was further divided into insufficient [25(OH)D_(3)<30 ng/mL] and deficient [25(OH)D_(3)<20 ng/mL]level, then all data were compared and analyzed between two groups. Results Compared with the healthy control group, the PCOS group was more prone to have oligomenorrhea or amenorrhea, the incidence of acne was higher in PCOS group than in control group(all P values<0.05). BMI, the levels of AMH, total testosterone and dehydroepiandrosterone sulfate were significantly higher in the PCOS group compared to the control group, while 25(OH)D_(3)was the opposite(all P values <0.05). AMH in the PCOS group was positively correlated with BMI and level of total testosterone, and negatively correlated with 25(OH)D_(3)(all P values<0.05). The AMH level in the 25(OH)D_(3)deficiency group was higher than that in the 25(OH)D_(3)insufficient group, the AMH levels of the 25(OH)D_(3)deficient group and control group were higher than that in the 25(OH)D_(3)insufficient group, the differences were statistically significant(P<0.05). The 25(OH)D_(3)deficiency rate in the healthy control group was 67.1%(57/85), while the 25(OH)D_(3)deficiency rate in the PCOS group was 96.2%(76/79). The difference between the two groups was statistically significant(χ^(2)=22.68, P<0.001). Conclusions Serum 25(OH)D_(3)level was an independent factor significantly associated with AMH level in adolescents with PCOS. AMH and 25(OH)D_(3)levels may be used as surrogate markers of PCOS risk in adolescents.