Endocrine Abstracts

Introduction: The diagnostic criteria of polycystic ovary syndrome (PCOS) are still under discussion and the hormonal parameters, including anti-Mullerian hormone range and hyperandrogenism, are not determined. Serum AMH level has been proposed as a surrogate marker for PCOM and could, therefore, be integrated in the diagnostic classifications for PCOS\. The aim of the present study was to characterize hormonal features of PCOS and to establish the most important hormonal parameters for PCOS diagnosis.

Design: A case-control study.

Methods: The study included 60 women with PCOS according to the complete Rotterdam criteria, aged 18-40 years. The control group consisted of 60 healthy women with a regular menstrual cycle of the same age. Hormonal assays, and ultrasound of the pelvic organs were performed. The diagnostic accuracy of AMH, follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, testosterone (T), dehydroepiandrosterone sulfate (DHEAS), sex hormone-binding globulin (SHBG) and free androgen index (FAI) in predicting PCOS was established using a logistic regression model and calculating area under the receiver operator characteristic (ROC) curve (AUC).

Results: PCOS women had higher levels of serum LH (p< 0.01), T (p< 0.01), AMH (p< 0.01), FAI (p< 0.01), DHEAS (p< 0.01), estradiol (P<0.01), 17-OH PG (p< 0.01) and significantly lower SHBG level (p< 0.01) and FSH level (p< 0.01) compared to healthy women. Testosterone level > 0.41 ng/ml showed the highest sensitivity (85.0%) and specificity (96.7%) for PCOS diagnosis. The level of AMH > 4.69 ng/ml also showed high sensitivity of 75% and specificity of 75% in PCOS diagnosis in the studied sample. The diagnostic accuracy of PCOS reached 94,2% with the combined use of hormonal indexes, which was significantly higher than the use of each index separately.

Conclusions: The results of the study estimate the threshold for AMH and T which could be suggested for use in the PCOS diagnostics with a high sensitivity and specificity. Moreover, the combination of hormonal indexes improved the diagnostic accuracy for the PCOS detection. Keywords: polycystic ovary syndrome, hyperandrogenism, testosterone, anti-Müllerian hormone, threshold