血清抗缪勒氏管激素联合促黄体生成素/卵泡刺激素和稳态模型胰岛素抵抗指数在诊断多囊卵巢综合征患者中的应用

The clinical application of serum anti-Mullerian hormone combined with luteinizing hormone/follicle stimulating hormone and homeostatic model insulin resistance index in the diagnosis of polycystic ovary syndrome

目的探讨抗缪勒氏管激素(AMH)、促黄体生成素/卵泡刺激素(LH/FSH)和稳态模型胰岛素抵抗指数(HOMA-IR)对多囊卵巢综合征(PCOS)的诊断意义。方法收集从温州医科大学附属第一医院收治的PCOS患者463例以及同期健康体检者268例,于月经周期第3天~5天或闭经状态下检测2组血清相关内分泌及生化指标。结果PCOS组患者血清除E2、PRL及TC外,均高于正常对照组(P<0.01),Pearson相关分析显示,PCOS组AMH与T、LH、HDL-C和LH/FSH之间呈弱相关关系,当AMH取6.18 ng/ml时,诊断灵敏度和特异度分别为82.8%和81.1%;AMH联合LH/FSH和HOMA-IR诊断PCOS时,AUC为0.930,其诊断灵敏度和特异度分别为87.0%和88.0%。结论PCOS患者血清AMH异常升高与内分泌激素水平密切相关,联合检测对PCOS的诊疗具有一定临床价值。

Objective To explore the value of serum anti-Mullerian hormone(AMH),luteinizing hormone/follicle stimulating hormone(LH/FSH)and homeostatic model insulin resistance index(HOMA-IR)in the diagnosis of polycystic ovary syndrome(PCOS).Methods A total of 463 PCOS patients and 268 healthy women were collected from the First Affiliated Hospital of Wenzhou Medical University.The endocrine and biochemical indexes were measured on the 3-5 day of menstrual cycle or the state of amenorrhea.Results The serum indexes in PCOS group were significantly higher than that in control group except E2,PRL and TC(P<0.01).Pearson correlation analysis showed that AMH was weak correlated with serum T,LH,HDL-C and LH/FSH levels in PCOS group.The sensitivity and specificity were 82.8%and 81.1%when the serum AMH in PCOS group was 6.18 ng/ml.The area under curve of combined detection of AMH,LH/FSH and HOMA-IR for diagnosing PCOS was 0.930.Moreover,the sensitivity and specificity were up to 87.0%and 88.0%.Conclusion The abnormal increasing of AMH in patients with PCOS is closely related to the endocrine hormone levels and combined detection provides clinical value for the diagnosis and treatment of PCOS.