Polikistik Over Sendromu Fenotiplerine Göre Anti-Müllerian Hormon Değerleri

Year 2024, Volume: 6 Issue: 3, 77 - 84, 26.09.2024

Serkan Polat , Osmna Nuri Erginay

https://doi.org/10.46969/EZH.1482404

Abstract

Amaç: Bu çalışmanın amacı polikistik over sendromlu (PKOS) hastalarda fenotipik özelliklere göre antimüllerian hormon düzeyini araştırmaktır.
Gereç ve Yöntemler: Bu çalışma kesitsel bir kohort çalışması olarak tasarlandı ve Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi PKOS kliniğine başvuran hastalar dahil edilmiştir. Anti-mullerain hormon (AMH) düzeyleri fenotip değerlendirmesine göre kaydedilmiştir.
Bulgular: Çalışmaya toplam 118 PKOS hastası katılmıştır. Buna göre 47 hasta (%39.8) fenotip A, 15 hasta (%12.7) fenotip B, 37 hasta (%31.3) fenotip C ve 19 hasta (%16.1) fenotip D’dir. Hastaların yaş ortalaması 22.97±4.98 yıldır. Ortalama vücut kitle indeksi 26.1± 4.26 kg/m2’dir. PKOS polikliniğine en sık başvuru nedeni adet düzensizliğidir. Fenotip A (%80.9) ve fenotip D’de (%84.2) PKOS polikliniğine en sık başvuru nedeni adet düzensizliğidir. Polikistik over morfolojisi (PKOM) varlığı ve over disfonksiyonu sıklığının fenotipe göre dağılımında gruplar arasında fark vardır (p<0.001, p<0.001). Fenotipe göre ortanca AMH düzeyleri (ng/ml) arasında istatistiksel olarak anlamlı bir fark bulunmuştur (p<0.001). Ortanca değer fenotip A’da 6,3 ng/ml, fenotip B’de 2,4 ng/ml, grup C’de 6,1 ng/ml ve fenotip D’de 6,6 ng/ml’dir.
Sonuç: Çalışmamızda fenotip A en sık gözlenen gruptur ve AMH düzeyleri fenotip D grubunda diğer gruplara göre anlamlı olarak daha yüksektir.

Keywords

Fenotip, polikistik over sendromu, anti müllerian hormon, Ferriman Gallwey skoru.

Ethical Statement

Bu araştırma için Etlik Zübeyde Hanım Kadın Sağlığı Eğitim ve Araştırma Hastanesi Girişimsel Olmayan Çalışmalar Etik Kurulundan onay alınmıştır (Karar no: 20/03/2024, 03/13).

Supporting Institution

Yok

Thanks

yok

Anti-Mullerian Hormone According to Polycystic Ovary Syndrome Phenotypes

Abstract

Objective: The aim of this study was to investigate the level of antimullerian hormone in patients with polycystic ovary syndrome (PCOS) according to phenotypic characteristics.
Materials and Methods: This study was designed as a cross-sectional cohort study and included patients attending the PCOS clinic of Etlik Zübeyde Hanım Gynecology Training and Research Hospital. Anti-mullerain hormone (AMH) levels were recorded according to phenotype assessment.
Results: A total of 118 patients with PCOS participated in the study. Accordingly, 47 patients (39.8%) belonged to phenotype A, 15 patients (12.7%) to phenotype B, 37 patients (31.3%) to phenotype C and 19 patients (16.1%) to phenotype D. The mean age of the patients was 22.97±4.98 years. The mean body mass index was 26.1± 4.26 kg/m2. The most common reason for presentation to the PCOS outpatient clinic was irregular menstruation. The most common reason for presentation to the PCOS outpatient clinic was irregular menstruation in phenotype A (80.9%) and phenotype D (84.2%). There was a difference between the groups in the distribution of the presence of polycystic ovarian morphology (PCOM) and the frequency of ovarian dysfunction by phenotype (p<0.001, p<0.001). A statistically significant difference was found between median AMH levels (ng/ml) according to phenotype (p<0.001). The median value was 6.3 ng/ml in phenotype A, 2.4 ng/ml in phenotype B, 6.1 ng/ml in group C and 6.6 ng/ml in phenotype D.
Conclusion: In our study, phenotype A was the most frequently observed group and AMH levels were significantly higher in the phenotype D group than in the other groups.

Keywords

Phenotype, polycystic ovary syndrome, anti mullerian hormone, Ferriman Gallwey score.

Ethical Statement

The study was approved by the Ethics Committee for Noninterventional Studies of Etlik Zubeyde Hanım Women Health Education Research Hospital (Approval date: 20/03/2024 Issue No.: 03/13).

Supporting Institution

None

Thanks

none

References

• Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, Yildiz BO. The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab. 2004;89(6):2745-9. https://doi.org/10.1210/jc.2003-032046
• Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19-25. https://doi.org/10.1016/j.fertnstert.2003.10.004
• Barrea L, Arnone A, Annunziata G, et al. Adherence to the Mediterranean Diet, Dietary Patterns and Body Composition in Women with Polycystic Ovary Syndrome (PCOS). Nutrients. 2019;11(10):2278. https://doi.org/10.3390/nu11102278
• Teede HJ, Tay CT, Laven JJE, et al; International PCOS Network. Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Eur J Endocrinol. 2023;189(2):G43-64. https://doi.org/10.1093/ejendo/lvad096
• Yilmaz M, Isaoglu U, Delibas IB, Kadanali S. Anthropometric, clinical and laboratory comparison of four phenotypes of polycystic ovary syndrome based on Rotterdam criteria. J Obstet Gynaecol Res. 2011;37(8):1020-6. https://doi.org/10.1111/j.1447-0756.2010.01478.x
• Tian X, Ruan X, Du J, Cheng J, Ju R, Mueck AO. Sexual function in Chinese women with different clinical phenotypes of polycystic ovary syndrome. Gynecol Endocrinol. 2023;39(1):2221736. https://doi.org/10.1080/09513590.2023.2221736
• Cook CL, Siow Y, Brenner AG, Fallat ME. Relationship between serum müllerian-inhibiting substance and other reproductive hormones in untreated women with polycystic ovary syndrome and normal women. Fertil Steril. 2002;77(1):141-6. https://doi.org/10.1016/s0015-0282(01)02944-2
• Seifer DB, Maclaughlin DT. Mullerian Inhibiting Substance is an ovarian growth factor of emerging clinical significance. Fertil Steril. 2007;88(3):539-46. https://doi.org/10.1016/j.fertnstert.2007.02.014
• Piouka A, Farmakiotis D, Katsikis I, Macut D, Gerou S, Panidis D. Anti-Mullerian hormone levels reflect severity of PCOS but are negatively influenced by obesity: relationship with increased luteinizing hormone levels. Am J Physiol Endocrinol Metab. 2009;296(2):E238-43. https://doi.org/10.1152/ajpendo.90684.2008
• Sahmay S, Atakul N, Oncul M, Tuten A, Aydogan B, Seyisoglu H. Serum anti-Mullerian hormone levels in the main phenotypes of polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol. 2013;170(1):157-61. https://doi.org/10.1016/j.ejogrb.2013.05.019
• Sova H, Unkila-Kallio L, Tiitinen A, et al. Hormone profiling, including anti-Müllerian hormone (AMH), for the diagnosis of polycystic ovary syndrome (PCOS) and characterization of PCOS phenotypes. Gynecol Endocrinol. 2019;35(7):595-600. https://doi.org/10.1080/09513590.2018.1559807
• Jamil AS, Alalaf SK, Al-Tawil NG, Al-Shawaf T. Comparison of clinical and hormonal characteristics among four phenotypes of polycystic ovary syndrome based on the Rotterdam criteria. Arch Gynecol Obstet. 2016;293(2):447-56. https://doi.org/10.1007/s00404-015-3889-5
• Ozay AC, Emekcı Ozay O, Gulekli B. Comparison of Anti-müllerian Hormone (AMH) and Hormonal Assays for Phenotypic Classification of Polycystic Ovary Syndrome. Ginekol Pol. 2020;91(11):661-7. https://doi.org/10.5603/GP.a2020.0122
• Tatar ÖB, Erginay ON, Akdaş Reis Y. Clinical and Demographic Characteristics of Patients Diagnosed with Polycystic Ovary Syndrome: A Cross-Sectional Observational Study. Türk Kadın Sağlığı ve Neonatoloji Dergisi. 2024;6(1):1-7. https://doi.org/10.46969/EZH.1445385
• Bozdag G, Mumusoglu S, Coskun ZY, Yarali H, Yildiz BO. Anti-Müllerian hormone as a diagnostic tool for PCOS under different diagnostic criteria in an unselected population. Reprod Biomed Online. 2019;39(3):522-9. https://doi.org/10.1016/j.rbmo.2019.04.002
• Dewailly D, Gronier H, Poncelet E, et al. Diagnosis of polycystic ovary syndrome (PCOS): revisiting the threshold values of follicle count on ultrasound and of the serum AMH level for the definition of polycystic ovaries. Hum Reprod. 2011;26(11):3123-9. https://doi.org/10.1093/humrep/der297
• Gürsu T, Eraslan A, Angun B. Comparison of body mass index, anti-müllerian hormone and insulin resistance parameters among different phenotypes of polycystic ovary syndrome. Gynecol Obstet Clin Med. 2022;2(4):164-70. https://doi.org/10.1016/j.gocm.2022.10.002
• Eralp B, Ibanoglu MC, Engin-Ustun Y. Evaluation of pregnancy and neonatal outcomes according to the phenotypic types of polycystic ovary syndrome: A prospective study. Int J Gynaecol Obstet. 2023;163(3):894-903. https://doi.org/10.1002/ijgo.14882
• Gupta M, Yadav R, Mahey R, et al. Correlation of body mass index (BMI), anti-mullerian hormone (AMH), and insulin resistance among different polycystic ovary syndrome (PCOS) phenotypes - a cross-sectional study. Gynecol Endocrinol. 2019;35(11):970-3. https://doi.org/10.1080/09513590.2019.1613640
• Panidis D, Tziomalos K, Misichronis G, et al. Insulin resistance and endocrine characteristics of the different phenotypes of polycystic ovary syndrome: a prospective study. Hum Reprod. 2012;27(2):541-9. https://doi.org/10.1093/humrep/der418
• Sobti S, Dewan R, Ranga S. Metabolic syndrome and insulin resistance in PCOS phenotypes. Int J Reprod Contracept Obstet Gynecol. 2017;6(11):5067-73. https://doi.org/10.18203/2320-1770.ijrcog20175027
• Guastella E, Longo RA, Carmina E. Clinical and endocrine characteristics of the main polycystic ovary syndrome phenotypes. Fertil Steril. 2010;94(6):2197-201. https://doi.org/10.1016/j.fertnstert.2010.02.014