title: Elevated LH levels draw a stronger distinction than AMH in premature ovarian insufficiency.
abstract: OBJECTIVE
  A significant number of individuals have high serum follicle stimulating hormone (FSH) levels but do not meet the criteria for diagnosis of premature ovarian insufficiency (POI) due to ongoing menstruation. We compared a group of women with elevated FSH levels and POI with a control group in terms of biochemical markers.
  
  
  METHODS
  In this cross-sectional retrospective study, 38 POI cases and 48 cases of elevated FSH were compared to 89 individuals in a control arm in terms of biochemical markers. The receiver operating characteristics curve was calculated to assess the utility of anti-Müllerian hormone (AMH) levels to discriminate women with elevated FSH levels accompanied by POI from those women with elevated FSH levels but not defineable as having POI.
  
  
  RESULTS
  A multiple regression analysis revealed that only the AMH level was significantly different for the discrimination between the control and elevated FSH groups. AMH and estradiol levels were found to be statistically significant for the discrimination between control and POI cases. However, only luteinizing hormone (LH) was found to be significant for distinguishing between women with elevated FSH and POI, interestingly excluding the serum AMH level in this context.
  
  
  CONCLUSIONS
  AMH was the most important and superior marker to differentiate both POI cases and patients with an elevated FSH level from the controls; however, it did not show the same resolution for differentiating POI cases from those with elevated FSH. Moreover, we conclude that the serum LH level is the most useful marker for differentiating POI cases from women with elevated FSH levels.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, Cerrahpasa Medical Faculty, Istanbul University , Istanbul.
authors.forename: S
authors.initials: S
authors.lastname: Sahmay
authors.forename: T A
authors.initials: TA
authors.lastname: Usta
authors.forename: T
authors.initials: T
authors.lastname: Erel
authors.forename: N
authors.initials: N
authors.lastname: Atakul
authors.forename: B
authors.initials: B
authors.lastname: Aydogan
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood*; D016649:Primary Ovarian Insufficiency / Q000097:blood*; D012044:Regression Analysis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone