不同年龄段多囊卵巢综合征患者抗苗勒管激素与体重指数的相关性研究

Correlation of anti-mullerian hormone with body mass index in patients with Polycystic Ovary Syndrome at different ages

目的探究不同年龄段多囊卵巢综合征(PCOS)患者血清抗苗勒管激素(AMH)水平与体重指数的相关性。方法选取遵义医科大学附属医院内分泌科及生殖中心诊断为PCOS的患者159例,根据年龄分成低龄组(≤35岁)和高龄组(>35岁),各组再根据体重指数(BMI)分为2个组,正常体重组和超重及肥胖组。对所有研究对象的激素等指标进行回顾性分析,比较各组患者的AMH水平差异及可能影响AMH的因素。结果无论低龄或高龄,超重及肥胖组患者总睾酮(T)、游离睾酮指数(FTI)及尿酸水平均显著高于正常体重组(低龄组:P_(T)=0.037,P_(FTI)=0.031,P_(尿酸)=0.041;高龄组:P_(T)=0.041,P_(FTI)=0.037,P_(尿酸)=0.039),且超重及肥胖组患者窦卵泡数(AFC)水平显著低于正常体重组(P_(低龄)=0.011,P_(高龄)=0.016);与低龄正常体重组患者相比,低龄超重及肥胖组患者血清AMH水平明显降低(P=0.026)。多重线性回归分析结果显示:AMH水平在低龄组中与BMI负相关(β=-0.385,P=0.031),在高龄组中两者无显著相关性(P=0.086),与FSH水平负相关(β=-0.245,P=0.043)。2个组AMH水平均与AFC及T呈正相关(低龄组:P_(AFC)=0.002,P_(T)=0.015;高龄组:P_(AFC)<0.001,P_(T)=0.026),与年龄均无显著相关性(P_(低龄)=0.939,P_(高龄)=0.142)。结论低龄PCOS患者的BMI是血清AMH水平变化的独立影响因素,而高龄PCOS患者的BMI与血清AMH水平变化无关。PCOS患者的年龄不能独立预测血清AMH水平。低龄及高龄PCOS患者血清AMH水平均与AFC及T水平密切相关。

Objective To investigate the correlation between serum anti-mullerian hormone(AMH)levels and body mass index in patients with polycystic ovary syndrome(PCOS)at different ages.Methods One hundred and fifty-nine patients diagnosed with PCOS in the Department of Endocrinology and Fertility Center of Affiliated Hospital of Zunyi Medical University were selected and divided into young age group(≤35 years old)and old age group(>35 years old),and each group was further divided into two groups according to their body mass index(BMI),normal weight group and overweight and obese group.Hormonal and other indicators were detected and retrospectively analyzed to compare AMH levels and other factors that may affect AMH in each group.Results Total testosterone(T),free testosterone index(FTI)and uric acid levels were significantly higher in the overweight and obese group than in the normal weight group regardless of age(the young age group:P_(T)=0.037,P_(FTI)=0.031,P_(uric acid)=0.041;the old age group:P_(T)=0.041,P_(FTI)=0.037,P_(uric acid)=0.039),and antral follicle count(AFC)levels were significantly lower in the overweight and obese group than in the normal weight group(P_(young)=0.011,P_(old)=0.016);serum AMH levels were significantly lower in the overweight and obese group of young age compared with the normal weight group of young age(P=0.026).Multiple linear regression analysis showed that AMH levels were negatively correlated with BMI in the young age group(β=-0.385,P=0.031),but not in the old age group(P=0.086),and negatively correlated with FSH levels(β=-0.245,P=0.043).AMH levels were positively correlated with AFC and T in both groups(the young age group:P_(AFC)=0.002,P_(T)=0.015;the old age group:P_(AFC)<0.001,P_(T)=0.026),and there was no significant correlation with age(P_(young)=0.939,P_(old)=0.142).Conclusion BMI was an independent factor influencing serum AMH levels in young PCOS patients,whereas BMI was not associated with changes in serum AMH levels in old PCOS patients.Age of PCOS patients was not an independent predictor of serum AMH levels.Serum AMH levels were strongly correlated with AFC and T levels in both young and old PCOS patients.