title: Polycystic ovarian morphology in adolescents with regular menstrual cycles is associated with elevated anti-Mullerian hormone.
abstract: BACKGROUND
  The significance of polycystic ovarian morphology (PCOM) during adolescence is not clear. The aim of this study was to determine the relationship between PCOM and anti-Müllerian hormone (AMH), inhibin B, testosterone and insulin levels in healthy girls during the second decade of life. We also determined whether AMH could be used as a surrogate marker of PCOM during adolescence.
  
  
  METHODS
  Seventy-four non-obese adolescents (age range: 13.5-19.75 years old) with regular menstrual cycles participated in this study. Transabdominal ultrasound and blood samples were obtained during the follicular phase.
  
  
  RESULTS
  PCOM was present in 33.8% of the subjects. Girls with PCOM had higher AMH levels than girls without PCOM (72.5 ± 6.1 versus 33.4 ± 2.6 pmol/l; P < 0.0001) and lower FSH levels (5.4 ± 0.3 versus 6.2 ± 0.2 mUI/ml; P < 0.036). Similar levels of inhibin B, androgens and LH were observed in girls with and without PCOM. PCOM prevalence and AMH levels were not associated with age (P = 0.745 and 0.2, respectively) or BMI-SDS (P = 0.951 and 0.096, respectively). AMH levels positively correlated with the of 2-5 mm follicle number. AMH levels ≥ 60.15 pmol/l had a sensitivity and specificity of 64.0 and 89.8%, respectively, to diagnose PCOM (area under the curve = 0.873).
  
  
  CONCLUSIONS
  These data confirm that PCOM in healthy non-hyperandrogenic girls with regular menstrual cycles is prevalent and is not associated with hyperandrogenism. The elevated AMH and lower FSH levels observed in healthy girls with regular menses and PCOM suggest that this ovarian pattern is secondary to a larger number of 2-5 mm follicles. An elevated AMH level is suggestive of the presence of PCOM during adolescence.
authors.affiliation: Institute of Maternal and Child Research, IDIMI, School of Medicine, University of Chile, Casilla 226-3, Santiago, Chile.
authors.forename: C
authors.initials: C
authors.lastname: Villarroel
authors.forename: P M
authors.initials: PM
authors.lastname: Merino
authors.forename: P
authors.initials: P
authors.lastname: López
authors.forename: F C
authors.initials: FC
authors.lastname: Eyzaguirre
authors.forename: A
authors.initials: A
authors.lastname: Van Velzen
authors.forename: G
authors.initials: G
authors.lastname: Iñiguez
authors.forename: E
authors.initials: E
authors.lastname: Codner
mesh_terms: D000293:Adolescent; D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D005260:Female; D005786:Gene Expression Regulation; D006801:Humans; D017588:Hyperandrogenism / Q000175:diagnosis; D007265:Inhibins / Q000097:blood; D007328:Insulin / Q000097:blood; D008597:Menstrual Cycle / Q000502:physiology*; D010053:Ovary / Q000000981:diagnostic imaging; D011085:Polycystic Ovary Syndrome / Q000473:pathology*; D012372:ROC Curve; D013739:Testosterone / Q000097:blood; D014463:Ultrasonography
chemical_list: D007328:Insulin; C422364:inhibin B; D013739:Testosterone; D007265:Inhibins; D054304:Anti-Mullerian Hormone