CONTEXT: Anti-Müllerian hormone (AMH) measured in adolescence as biomarker for prediction of adult polycystic ovary syndrome (PCOS) is doubtful but not substantiated.
OBJECTIVE: To investigate whether serum AMH levels and other PCOS associated features in adolescence can predict the presence of PCOS in adulthood.
DESIGN AND SETTING: A long-term follow-up study based on an unique adolescent study on menstrual irregularities performed between 1990-1997.
PARTICIPANTS AND INTERVENTIONS: AMH was assayed in 271 adolescent girls. Data on PCOS features were combined with AMH levels. In 160 of the 271 (59%) participants we collected information in adulthood about their menstrual cycle pattern and presence of PCOS (features) by questionnaire two decades after the initial study.
RESULTS: AMH was higher in adolescent girls with oligomenorrhea compared to girls with regular cycles, median (IQR): 4.6(3.1-7.5) versus 2.6(1.7-3.8) μg/L (P<0.001). Women with PCOS in adulthood had a higher median adolescent AMH of 6.0 compared to 2.5 μg/L in the non-PCOS group (P<0.001). AMH at adolescence showed an area under the ROC curve for PCOS in adulthood of 0.78. In adolescent girls with oligomenorrhea the proportion developing PCOS in adulthood was 22.5% (95% CI, 12.4-37.4%) against 5.1% (95% CI, 2.1-12.0%) in girls with a regular cycle (P=0.005). Given adolescent oligomenorrhea, adding high AMH as factor to predict adult PCOS or adult oligomenorrhea was of no value.
CONCLUSIONS: Adolescent AMH either alone or adjuvant to adolescent oligomenorrhea does not contribute as prognostic marker for PCOS in adulthood. Therefore, we do not recommend routine its use in clinical practice.
|Journal||The Journal of clinical endocrinology and metabolism|
|Publication status||E-pub ahead of print - 22 Dec 2020|