目的:在多囊卵巢综合征(PCOS)的诊断标准中建立抗苗勒管激素(AMH)和窦卵泡计数(AFC)的临界值,该标准适用于日本妇产科学会(JSOG)标准和鹿特丹/2024国际循证指南,基于2023年的全国范围的PCOS评估和管理(IEBG)调查标准分别,考虑到年龄,化验,和诊断标准的结构。
方法:使用日本全国调查收集了986例PCOS病例和965例对照病例的数据,并用于确定AMH和AFC的临界值。
结果:PCOS组的血清AMH水平明显高于对照组。血清AMH与年龄呈显著负相关,与AFC呈显著正相关。在多元回归分析中,血清AMH水平独立受AFC和总睾酮的影响。分别为20-29岁和30-39岁年龄组建立了适用于JSOG2024标准和鹿特丹/IEBG2023标准的AMH截止值,分别,对于Access,Lumipulse和Elecsys/ECLusys,分别。还分别建立了适用于JSOG2024标准和鹿特丹/IEBG2023标准的AFC截止值。AFC在统计学上表现出比AMH更大的变异性。
结论:血清AMH水平是PCOS卵巢表现的生化表征,被认为是客观和高度可靠的。因此,它可以作为AFC的替代指标,作为诊断标准中多囊卵巢形态的标志物。
OBJECTIVE: To establish cut-off values for anti-Müllerian hormone (AMH) and antral follicle count (AFC) in the diagnostic criteria for polycystic ovary syndrome (PCOS) applicable to the Japan Society of Obstetrics and Gynecology (JSOG) 2024 criteria and the Rotterdam/International Evidence-Based Guideline for the assessment and management of PCOS (IEBG) 2023 criteria based on a nationwide survey, respectively, taking into account age, assays, and structure of the diagnostic criteria.
METHODS: Data were collected for 986 PCOS cases and 965 control cases using a national survey in Japan and used to establish cut-off values for AMH and AFC.
RESULTS: Serum AMH levels were significantly higher in the PCOS group compared to the control group. Serum AMH showed a significant negative correlation with age and significant positive correlation with AFC in both groups. In multiple regression analysis, serum AMH level was independently affected by AFC and total testosterone. AMH cut-off values suitable for the JSOG 2024 criteria and the Rotterdam/IEBG 2023 criteria were separately established for the 20-29 and 30-39 years of age groups, respectively, and for Access, Lumipulse and Elecsys/ECLusys, respectively. AFC cut-off values suitable for the JSOG 2024 criteria and Rotterdam/IEBG 2023 criteria were also established separately. AFC exhibited statistically greater variability than AMH.
CONCLUSIONS: The serum AMH level is the biochemical representation of ovarian findings in PCOS and considered objective and highly reliable. Therefore, it could serve as a surrogate for AFC as a marker of polycystic ovarian morphology in diagnostic criteria.