RESUMO
PCOS has a leading place in women's infertility. Based on the data of recent researches, Anti-Mullerian hormone (AMH) has been considered as one of the diagnostic criteria for PCOS. The aim of study was to determine the correlation of Anti-Mullerian hormone with hormonal and ovarian morphological characteristics in patients with PCOS, with and without insulin resistance. 110 women with diagnosis of PCOS were involved in the study. Patients were divided into two groups: PCOS patients with insulin resistance (60 women) and PCOS patients without insulin resistance (50 women). All patients underwent hormonal investigation (AMH, FSH, LH, T, FT, HOMA- IR, FAI and SHBG). The volume of ovaries and the number of antral follicles (AFC) were determined by ultrasound imaging. Сorrelation between AMH and the ovarian hormonal and morphological characteristics has been shown. In particular, a significant positive correlation between AMH and the volume of the ovaries in both groups was demonstrated. In the group of patients with PCOS and insulin resistance a positive correlation between AMH and the volum of ovary, AFC was shown, as well as a negative correlation between AMH and SHBG. In the same group a tendency of the positive correlation between AMH and TT, HOMA-IR and IRI was seen. In the group of patients with PCOS without insulin resistence a positive correlation between AMH and the volum of ovary was observed, as well as the tendency of positive correlation between AMH and AFC, TT, HOMA-IR, IRI. Additionally, a negative correlation between AMH and SHBG was seen in the later patient group. Increased levels of AMH in all PCOS patients in our study, in comparison with the accepted norm, indicates on possibility of using this data in the diagnosis of PCOS. AMH levels in PCOS patients with and without insulin resistance do not differ significantly. The correlation between AMH and the morphological characteristics of ovaries has been established.
Assuntos
Hormônio Antimülleriano/genética , Hormônio Foliculoestimulante/genética , Resistência à Insulina , Hormônio Luteinizante/genética , Folículo Ovariano/metabolismo , Síndrome do Ovário Policístico/genética , Adolescente , Adulto , Hormônio Antimülleriano/sangue , Biomarcadores/sangue , Feminino , Hormônio Foliculoestimulante/sangue , Expressão Gênica , Humanos , Insulina/sangue , Hormônio Luteinizante/sangue , Tamanho do Órgão , Folículo Ovariano/diagnóstico por imagem , Folículo Ovariano/patologia , Síndrome do Ovário Policístico/sangue , Síndrome do Ovário Policístico/diagnóstico por imagem , Síndrome do Ovário Policístico/patologia , Globulina de Ligação a Hormônio Sexual/genética , Globulina de Ligação a Hormônio Sexual/metabolismo , Testosterona/sangue , Testosterona/genética , UltrassonografiaRESUMO
Both extreme underweight or overweight negatively affects reproductive health, but evidence is inconsistent in terms of mechanisms by which low or high BMI causes reproductive problems. The aim of our study was to investigate associations of sex steroids and gonadotropins with BMI in underweight and overweight patients since childhood. In this study 48 underweight and 55 overweight/obese females underwent full clinical-hormonal analyses. Polycystic ovarian syndrome and metabolic syndrome was the most frequent in overweight and obese patients, whilst non-classical congenital adrenal hyperplasia and ovarian dysfunction prevailed in underweight patients (P=.000). FSH (P=.013) and SHBG (P=.000) levels were higher in patients with low BMI, whilst FT (p=.019) and TT (p=.003) levels were higher in high BMI patients. No difference was found in terms of AMH (P>.05). BMI negatively correlated with FSH (P=.009) and SHBG (P=.001) and positively correlated with FT (P=.001) and TT (P=.002). So sex steroid and gonadotropin levels are determined by particular reproductive disorders, which are associated to childhood BMI and progression of BMI changes.
