title: The Role of Anti-Müllerian Hormone in the Characterization of the Different Polycystic Ovary Syndrome Phenotypes.
abstract: Rotterdam criteria identified 4 polycystic ovary syndrome (PCOS) phenotypes based on the combination of anovulation (ANOV), hyperandrogenism (HA), and polycystic ovaries (PCOs): phenotype 1 (ANOV + HA + PCO), phenotype 2 (ANOV + HA), phenotype 3 (HA + PCO), and phenotype 4 (ANOV + PCO). Anti-Müllerian hormone (AMH) was suggested to play a pathophysiologic and diagnostic role in this syndrome. The aim of this study was to compare AMH levels among the different phenotypes in relation to clinical, endocrine, and metabolic features. We enrolled 117 women with PCOS (body mass index: 25.89 ± 6.20 kg/m(2), age range: 18-37 years) and 24 controls. Anthropometric characteristics, hirsutism score, ultrasound ovarian features, and hormonal parameters, including AMH, were evaluated. Each participant also underwent an oral glucose tolerance test and an euglycemic-hyperinsulinemic clamp. The prevalence of phenotypes 1 to 4 was 62.4%, 8.6%, 11.1%, and 17.9%, respectively. Body mass index and insulin resistance indexes were similar among the groups. Phenotype 1 showed the highest luteinizing hormone, androgens levels, ovarian volume, and AMH concentrations (9.27 ± 8.17 ng/mL,P< .05) versus phenotype 2 and controls. Phenotype 2 women were hirsute, showed an intermediate free androgen index value, low ovarian volume, and low AMH levels (4.05 ± 4.12 ng/mL). Phenotype 3 showed an intermediate state of HA and slightly augmented AMH levels (5.87 ± 4.35 ng/mL). The clinical and endocrine characteristics of phenotype 4 resembled those of controls, except for higher ovarian volume and AMH levels (7.62 ± 3.85 ng/mL;P< .05). Our results highlight the heterogeneity of the association between increased AMH levels, menstrual dysfunction, and HA in the different PCOS phenotypes, thus offering a key to an understanding of the current controversy on the value of AMH measurement in PCOS.
authors.affiliation: Department of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Roma, Italia danielaromualdi@libero.it.
authors.forename: Daniela
authors.initials: D
authors.lastname: Romualdi
authors.affiliation: Department of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Roma, Italia.
authors.forename: C
authors.initials: C
authors.lastname: Di Florio
authors.affiliation: Department of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Roma, Italia.
authors.forename: V
authors.initials: V
authors.lastname: Tagliaferri
authors.affiliation: Department of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Roma, Italia.
authors.forename: S
authors.initials: S
authors.lastname: De Cicco
authors.affiliation: Department of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Roma, Italia.
authors.forename: D
authors.initials: D
authors.lastname: Gagliano
authors.affiliation: Department of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Roma, Italia.
authors.forename: V
authors.initials: V
authors.lastname: Immediata
authors.affiliation: Department of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Roma, Italia OASI Institute for Research, Troina, Italia.
authors.forename: A
authors.initials: A
authors.lastname: Lanzone
authors.affiliation: Department of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Roma, Italia Ospedale Generale Regionale "F. Miulli," Acquaviva delle Fonti, Italia.
authors.forename: M
authors.initials: M
authors.lastname: Guido
mesh_terms: D000293:Adolescent; D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D010641:Phenotype; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000000981:diagnostic imaging*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D054304:Anti-Mullerian Hormone
keywords: AMH; PCOS; PCOS phenotype