PCO病人體重下降，生殖功能改善，
AMH並不明顯下降
http://humrep.oxfordjournals.org/content/24/8/1976.long
The effect of weight loss on anti-Müllerian hormone levels in overweight and obese women with polycystic ovary syndrome and reproductive impairment.
BACKGROUND:
Anti-Müllerian hormone (AMH) has been proposed as a clinical predictor of improvements in reproductive function following weight loss in overweight and obese women with polycystic ovary syndrome (PCOS). This study aimed to assess whether baseline and/or change in AMH levels with weight loss predict improvements in reproductive function in overweight and obese women with PCOS.
METHODS:
Fifty-two overweight and obese women with PCOS and reproductive impairment (age 29.8 +/- 0.8 years, BMI 36.5 +/- 0.7 kg/m(2)) followed a 20-week weight loss programme. AMH, weight, menstrual cyclicity and ovulatory function were assessed at baseline and post-intervention.
RESULTS:
Participants who responded with improvements in reproductive function (n = 26) had lower baseline AMH levels (23.5 +/- 3.7 versus 32.5 +/- 2.9 pmol/l; P = 0.03) and experienced greater weight loss (-11.7 +/- 1.2 versus -6.4 +/- 0.9 kg; P = 0.001) compared with those who did not respond (n = 26). Logistic regression analysis showed that weight loss and baseline AMH were independently related to improvements in reproductive function (P = 0.002 and P = 0.013, respectively). AMH levels did not change with weight loss in both responders and non-responders.
CONCLUSIONS:
Table I
Weight, waist circumference, insulin resistance, hormonal parameters and AMH before and following weight loss for women who responded with improved reproductive function and those who did not (non-responders)
| Responders (n = 26) | Non-responders (n = 26) | |||
|---|---|---|---|---|
| Baseline | Change | Baseline | Change | |
| Weight (kg) | 104.2 ± 4.3 | −11.7 ± 1.2* | 99.0 ± 3.7 | −6.4 ± 0.9 |
| Waist circumference (cm) | 103.9 ± 2.8 | −12.3 ± 1.3* | 99.8 ± 2.2 | −8.4 ± 1.0 |
| Insulin (mU/l) | 15.9 ± 1.4 | −4.2 ± 0.7 | 16.8 ± 1.7 | −4.2 ± 1.2 |
| HOMA2 | 2.05 ± 0.18 | −0.56 ± 0.10 | 2.15 ± 0.21 | −0.53 ± 0.14 |
| Testosterone (nmol/l) | 2.50 ± 0.15 | −0.48 ± 0.11 | 2.68 ± 0.14 | −0.28 ± 0.10 |
| SHBG (nmol/l) | 31.0 ± 2.8 | 9.0 ± 2.1 | 31.1 ± 2.1 | 4.4 ± 1.9 |
| FAI | 9.38 ± 1.21 | −3.51 ± 0.81 | 9.89 ± 0.97 | −1.71 ± 0.76 |
| AMH (pmol/l) | 23.5 ± 3.7† | −1.9 ± 1.6 | 32.5 ± 2.9 | −1.6 ± 1.8 |
- Values are presented as mean ± SE. HOMA2, homeostatic model assessment of insulin resistance; SHBG, sex-hormone-binding globulin; FAI, free androgen index; AMH, anti-Müllerian hormone.
- *P < 0.02, significantly greater reduction in responders compared with non-responders.
- †P < 0.03, significantly lower when compared with non-responders at baseline.
Table II
Baseline AMH and the change in AMH following weight loss for women who were amenorrhoeic, anovulatory and oligo-ovulatory
| Baseline AMH (pmol/l) | Change in AMH (pmol/l) | |
|---|---|---|
| Amenorrhoeic (n = 8) | 44.0 ± 4.2 | −3.1 ± 2.3 |
| Anovulatory (n = 14) | 29.7 ± 4.8 | 0.3 ± 3.2 |
| Oligo-ovulatory (n = 30) | 22.9 ± 2.9* | −2.3 ± 1.3 |
- Values are presented as mean ± SE. AMH, anti-Müllerian hormone.
- *P = 0.006, significantly lower than amenorrhoeic participants.
沒有留言:
張貼留言