Please use this identifier to cite or link to this item: https://hdl.handle.net/2440/87822
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Type: Journal article
Title: Polycystic ovary syndrome and anti-Müllerian hormone: role of insulin resistance, androgens, obesity and gonadotrophins
Other Titles: Polycystic ovary syndrome and anti-Mullerian hormone: role of insulin resistance, androgens, obesity and gonadotrophins
Author: Cassar, S.
Teede, H.
Moran, L.
Joham, A.
Harrison, C.
Strauss, B.
Stepto, N.
Citation: Clinical Endocrinology, 2014; 81(6):899-906
Publisher: Wiley
Issue Date: 2014
ISSN: 0300-0664
1365-2265
Statement of
Responsibility: 
Samantha Cassar, Helena J. Teede, Lisa J. Moran, Anju E. Joham, Cheryce L. Harrison, Boyd J. Strauss and Nigel K. Stepto
Abstract: Objective: Polycystic ovary syndrome (PCOS) is a complex endocrine disorder associated with insulin resistance, hyperandrogenism, obesity, altered gonadotrophin release and anovulatory infertility. Anti-Müllerian hormone (AMH) has been proposed as a marker of ovarian function and fertility. Across a cohort of lean and overweight women with and without PCOS, we investigated the association of AMH with insulin resistance and body composition using gold standard measures. A secondary aim was to examine whether AMH was useful to determine PCOS status. Design: Cross-sectional study. Patients: A total of 22 lean and 21 overweight women with PCOS and 19 lean and 16 overweight non-PCOS healthy controls were recruited. PCOS was diagnosed based on the Rotterdam criteria. Measurements: Euglycaemic-hyperinsulinaemic clamp for assessing insulin resistance, dual energy X-ray absorptiometry and computed tomography for assessing adiposity, and blood sampling for the assessment of androgens, gonadotrophins and AMH. Results: Anti-Müllerian hormone levels were increased in women with PCOS (P <0·001) regardless of adiposity, with this increase associated with testosterone (P <0·001) rather than insulin resistance (P = 0·79), adiposity (P = 0·98) or gonadotrophins. In assessing the ability of AMH to predict PCOS, a value of 30 pmol/l or higher indicated 79% of women with PCOS were correctly identified as having the condition. Conclusion: Anti-Müllerian hormone appears primarily related to androgen status suggesting a direct and predominant role of androgens in the pathophysiology of reproductive dysfunction in PCOS. As AMH reflects PCOS status, it may also be useful in PCOS diagnosis.
Keywords: Humans
Polycystic Ovary Syndrome
Insulin Resistance
Obesity
Testosterone
Gonadotropins, Pituitary
Follicle Stimulating Hormone
Luteinizing Hormone
Insulin
Blood Glucose
Sex Hormone-Binding Globulin
Androgens
Tomography, X-Ray Computed
Absorptiometry, Photon
Glucose Clamp Technique
Case-Control Studies
Cross-Sectional Studies
Adult
Female
Adiposity
Overweight
Anti-Mullerian Hormone
Young Adult
Rights: © 2014 John Wiley & Sons Ltd
DOI: 10.1111/cen.12557
Grant ID: http://purl.org/au-research/grants/nhmrc/606553
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