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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 |
Published version: | http://dx.doi.org/10.1111/cen.12557 |
Appears in Collections: | Aurora harvest 2 Paediatrics publications |
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