Journal
JOURNAL OF ADOLESCENT HEALTH
Volume 60, Issue 3, Pages 333-339Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jadohealth.2016.10.015
Keywords
AMH; PCOS; Hyperandrogenemia; Obese adolescents
Funding
- National Institute of Child Health and Human Development [K24-HD01357, R01-HD27503]
- Richard L. Day Endowed Chair
- Pediatric Clinical and Translational Research Center (PCTRC) [UL1TR000005]
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Purpose: Anti-Mullerian hormone (AMH) is proposed as a biomarker of polycystic ovary syndrome (PCOS). This study investigated: (1) AMH concentrations in obese adolescents with PCOS versus without PCOS; (2) the relationship of AMH to sex steroid hormones, adiposity, and insulin resistance; and (3) the optimal AMH value and the multivariable prediction model to determine PCOS in obese adolescents. Methods: AMH levels were measured in 46 obese PCOS girls and 43 obese non-PCOS girls. Sex steroid hormones, clamp-measured insulin sensitivity and secretion, body composition, and abdominal adiposity were evaluated. Logistic regression and receiver-operating characteristic curve analyses were used, and multivariate prediction models were developed to test the utility of AMH for the diagnosis of PCOS. Results: AMH levels were higher in obese PCOS versus non-PCOS girls (8.3 +/- .6 vs. 4.3 +/- .4 ng/mL, p < .0001), of comparable age and puberty. AMH concentrations correlated positively with age in both groups, total and free testosterone in PCOS girls only, abdominal adipose tissue in non-PCOS girls, with no correlation to in vivo insulin sensitivity and secretion in either groups. A multivariate model including AMH (cutoff 6.26 ng/mL, area under the curve .788) together with sex hormone-binding globulin and total testosterone exhibited 93.4% predictive power for diagnosing PCOS. Conclusions: AMH may be a useful biomarker for the diagnosis of PCOS in obese adolescent girls. (C) 2016 Society for Adolescent Health and Medicine. All rights reserved.
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