title: Polycystic ovary syndrome and anti-Müllerian hormone: role of insulin resistance, androgens, obesity and gonadotrophins.
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.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: College of Sport and Exercise Science, Victoria University, Melbourne, Vic., Australia; Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, Vic., Australia; Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic., Australia.
authors.forename: Samantha
authors.initials: S
authors.lastname: Cassar
authors.forename: Helena J
authors.initials: HJ
authors.lastname: Teede
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Moran
authors.forename: Anju E
authors.initials: AE
authors.lastname: Joham
authors.forename: Cheryce L
authors.initials: CL
authors.lastname: Harrison
authors.forename: Boyd J
authors.initials: BJ
authors.lastname: Strauss
authors.forename: Nigel K
authors.initials: NK
authors.lastname: Stepto
mesh_terms: D015502:Absorptiometry, Photon; D050154:Adiposity; D000328:Adult; D000728:Androgens / Q000378:metabolism; D054304:Anti-Mullerian Hormone / Q000378:metabolism*; D001786:Blood Glucose / Q000378:metabolism; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D005640:Follicle Stimulating Hormone / Q000378:metabolism; D015309:Glucose Clamp Technique; D006065:Gonadotropins, Pituitary / Q000378:metabolism*; D006801:Humans; D007328:Insulin / Q000378:metabolism; D007333:Insulin Resistance; D007986:Luteinizing Hormone / Q000378:metabolism; D009765:Obesity / Q000378:metabolism*; D050177:Overweight / Q000378:metabolism; D011085:Polycystic Ovary Syndrome / Q000378:metabolism*; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D013739:Testosterone / Q000378:metabolism*; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D000728:Androgens; D001786:Blood Glucose; D006065:Gonadotropins, Pituitary; D007328:Insulin; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D054304:Anti-Mullerian Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone