Status of serum anti-mullerian hormone and lipid profile in polycystic ovarian syndrome: a cross-sectional study at tertiary care centre of central India
DOI:
https://doi.org/10.18203/2320-6012.ijrms20181291Keywords:
AMH (Anti-mullerian hormone), Follicle stimulating hormone, Hyperlipidemia, PCOS (polycystic ovarian syndrome)Abstract
Background: Polycystic ovarian syndrome (PCOS) is the most common cause of chronic anovulation in young women and affects 5 to 10 % of the female population. Anti-Mullerian Hormone (AMH) level indicate the quantity of the ovarian follicle pool and may be a useful marker of ovarian reserves. In order to establish the pattern of change in serum AMH level and its contribution in alteration of lipid metabolism and PCOS related complications the present study was planned.
Methods: Study was carried out in M.G.M. medical college, Govt Holker College and K. R. G’s Blessed mom centre from June -2016 to December -2017. The study population consisted total 50 women subjects among them 25 women suffering from PCOS aged between 18 to 35-year taken as case group and 25 age matched healthy women taken as control group. Fasting blood sample was collected from each subject and analyzed for AMH level and Lipid profile level.
Results: Results revealed that significantly increased serum AMH, cholesterol, triglycerides, LDL, VLDL levels and significantly decreased HDL levels were observed in PCOS cases when compare to control subjects.
Conclusions: Study concluded elevated AMH level leads to increase risk of polycystic ovarian syndrome and PCOS associated hyperlipidemia and other complications.
References
Berek JS. Novak’s Gynoecology, endocrine disorders. 14th Edi., 2007;1076-1088.
Zawadic JK, Danif A. Diagnostic Criteria for Polycystic ovary syndrome towards a rational approach. Backwell Sci. 1992;377-48.
Boomsma CM, Fauser BC, Macklon NS. Pregnancy complications in women with PCOS.” Semin Repord Med. 2008;26(1):27-84.
Speroff L, Fritz MA, editors. Clinical gynecologic endocrinology and infertility. lippincott Williams & wilkins. 2005;12:485-513.
Cate RL, Mattaliano RJ, Hession C, Tizard R, Farber NM, Cheung A, et al. Isolation of the bovine and human genes for Müllerian inhibiting substance and expression of the human gene in animal cells. Cell. 1986;45(5):685-98.
Cohen-Haguenauer O, Picard JY, Mattei MG, Serero S, Van Cong N, De Tand MF, et al. Mapping of the gene for anti-Müllerian hormone to the short arm of human chromosome 19. Cytogenetic Genome Res. 1987;44(1):2-6.
La Marca A, Volpe A. Anti‐Müllerian hormone (AMH) in female reproduction: is measurement of circulating AMH a useful tool?. Clin Endocrinol. 2006;64(6):603-10.
Rajpert-De Meyts E, Jørgensen N, Græm N, Müller J, Cate RL, Skakkebæk NE. Expression of anti-Mullerian hormone during normal and pathological gonadal development: association with differentiation of Sertoli and granulosa cells. J Clin Endocrinol Meta. 1999;84(10):3836-44.
Stubbs SA, Hardy K, Da Silva, Buttkus P, Stark J, Webber LJ, et al. AMH Protein expression is reduced during the initial stages of follicle development in human Polycystic Ovary. J Clni Endo Metab. 2005;90:5536-43.
Baarends WM, Uilenbroek JT, Kramer P, Hoogerbruge JW, Van Leeuwen EC, Themmen AP, et al. AMH and AMH Type II receptor messenger ribonucleic acid expression in rat ovaries during post natal development, the estrous cycle and gonadotropin induced follical growth. Endocrinol. 1995;136:4951-4962.
Pellatt L, Hanna L, Brincat M, Galea R, Brain H, Whitehead S, Mason H. Granulosa Cell production of AMH is increased in Polycystic Ovary. J Clin Endo Metab. 2007;92:240-8.
Adel F, Begaay, Akmal N, EI Mazny, Nemeen A, Abou Salem, Nagwa E, EI-Taweel. AMH in PCOS and normo ovulatory women : Correlation with clinical, hormonal and ultra sonography parameters. Middle East Fertility Soci J. 2010;15(4):253-8.
Weenen C, Laven J, Von Bergh A, Ganfiled M, Groome N, Themmen A. AMH expression pattern in the human ovary: potential implications for initial and cyclic follicle recruitment. Molecular Human reproduction. 2004;10(2):77-83.
Fablo M, Rocca M, Russo T, DEttore A, Toliho A, Zullo F, et. al. Serum and follicular AMH levels in women with PCOS under metformin. J ovarian Res. 2010;3:16.
Eldar-Geva T, Margalioth EJ, Gal M, Ben-chetrit A, Algar N, Zylber-Haran E, et al. Serum AMH levels during controlled ovarian hyperstimulation in women with PCO with and without hyperandrogenism”. Hum Reprod. 2005;20:1814-9.
Laven JS, Imani B, Eijkemans MJ, Faurer BC. New approach to PCOS and ather forms of anovulatory infertility. Obstet Gynecol. 2002;57:755-67.
Diamanti-Kandarakis E. Polycystic ovarian syndrome: pathophysiology, molecular aspects and clinical implications. Expert Reviews in molecular medicine. 2008;10:e3.
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. Ame J Physiology-Endocrinol Meta. 2009;296(2):E238-43.
Teede HJ, Misso ML, Deeks AA, Moran LJ, Stuckey BG, Wong JL, et al. Med J Australia. 2011;195(6):65.
Teede HJ, Misso ML, Deeks AA, Moran LJ, Stuckey BG, Wong JL, et al. Assessment and management of polycystic ovary syndrome: summary of an evidence-based guideline. Med J Australia. 2011;195(6):68-9.
Legro RS, Kunselman AR, Dunaif A. Prevalence and predictors of dyslipidemia in women with polycystic ovary syndrome. Ame J Med. 2001;111(8):607-13.
Stonge MP, Janssen I, Heymsfied SD. Metabolic syndrome in normal-weight Americans: New definition of the metabolically obese, normal weight individual. Diabetes care. 2004;27:2222-8.
Pepe I, Agrusa A, Rinella MR, Fertita E, Gulattu P. Scozzar I, et. al. Heterogenous forms of dyslipidemia in women with PCOS. Acta Medica Mediterranea. 2008;24:133-9.
Pigny P, Merlen E, Robert Y, Cortet-Rudelli C, Decanter C, Jonard S, et al. Elevated serum level of anti-mullerian hormone in patients with polycystic ovary syndrome: relationship to the ovarian follicle excess and to the follicular arrest. J Clin Endocrinol Meta. 2003;88(12):5957-62.
Hughedon PE. Morphology and morphogene of the stein-levelnthal ovary and of so-called hyperthecosis. Obsetl Gynecal. 1982;37(2):59-77.
Weenen C, Laven JS, Von Bergh AR, GanfieldM, Groome NP, Visser JA, et al. Antimullerian hormone expression pattern in human ovary: potential implication for initial and cyclic follicle recruitment. Mol Hum Repord. 2004;10(2):77-83.
Villarroel C, Merino PM, Lopez P, Eyzaguirre FC, Van Velzen A, Iniguez G, et al. Polycystic Ovarian morphology in adolescents with regular menstrual cycles in associatied with elevated anti-mullerian hormone. Hum Reprod. Oxford England. 2011;26(10):2861-8.
Catteau-Jonard S, Jamin SP, Leclere A, Gonzales J, Dewailly D, di clemente N. AMH, its receptor, FSH receptor and androgen receptor genes are overexprssed by granulosa cells from stimulated follicle in women with PCOS. J Clin Endocrinol Metab. 2008;93(11):4456-61.
Durlinger AL, Visser JA, Themmen AP. Regulation of ovarian function: the role of antimullerian hormone. Reporduction. 2002;124:601-9.
Erickson GF, Hsueh AJ, Quigley ME, Rebar RW, Yens S. Functional studies of aromatare activity in human granulosa cells from normal and PCO. J Clin Endocrinolmetab. 1979;49:514-9.
Sarma HN, Manikkam M, Herkimer C, Dell’Orco J, Welch KB, Foster DL, et al. Fetal programming: excess prenatal testosterone reduces postnatal luteinizing hormone, but not follicle-stimulating hormone responsiveness, to estradiol negative feedback in the female. Endocrinology. 2005;146(10):4281-91.
Buffington CK, Givens JR, Kibabchi AE. Opposing actions of dehydroepiandrosterone and testosterone on insulin sensitivity. Dia. 1992;40:693.
Teede HJ, Stuckey BG. PCOS and abnormal lipid and glucose tolerance. Med J Australia. 2007;187:324-5.
Tangvarasittichai S, Poonsub P, Tangvarasittichai O. Association of serum lipoprotein ratios with insulin resistance in type 2 diabetes mellitus. Ind J Med Res 2010:131:641-8.
Wild RA, Painter PC, Coulson PB, Carruth KB, Ranney GB. Lipoprotien lipid concentration and cardiovascular risk in women with PCOS. J Clin Endocrinol Metab. 1985;61:946-51.
Legro RS, Kunselmen AR, Dunaif A. Prevalence and predictors of dislipidemea in women with PCOS. AMJ Med. 2001;111:607-13.
