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다낭성 난소증후군의 항뮐러관 호르몬에 관한 연구

ANTI-MLERIAN HORMONE IN WOMEN WITH POLYCYSTIC OVARY SYNDROME

박소연|양가영|정경아|김영주|정혜원|유시연
대한산부인과학회 (Korean Soceity of Obstetrics and Gynecology)|2012.05|Obstetrics & Gynecology Science|제55권 제05호|pp. 315-324|DOI http://dx.doi.org/10.5468/KJOG.2012.55.5.315

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테스토스테론Polycystic ovary syndromeTestosteronePolycystic ovarian morphology다낭성 난소증후군항뮐러관 호르몬다낭성 난소 형태Anti-Mlerian hormone
주제분류산부인과학

초록

목적다낭성 난소증후군(polycystic ovary syndrome) 환자에서 항뮐러관 호르몬(anti-Müllerian hormone)을 측정하여 다낭성 난소증후군의 임상적, 생화학적 특징 및 관련 지표와의 상관 관계를 분석하고자 하였다. 연구방법Rotterdam European Society for Human Reproduction and Embryology기준에 따라 진단된 100명의 다낭성 난소증후군 환자에서 혈중 항뮐러관 호르몬을 측정하였다. 신체계측, 혈액검사, 질식 또는 직장 초음파검사를 시행하였다. 다낭성 난소 형태(polycystic ovarian morphology, PCOM)와 고안드로겐혈증에 근거한 표현형에 따라 4군으로 분류하여, 항뮐러관 호르몬과 인슐린 저항성 등의 다낭성 난소증후군 관련 지표들의 상관성을 비교 분석하였다. 결과다낭성 난소증후군의 항뮐러관 호르몬 농도는 4.1-21.0 ng/mL 범위에 있었으며 평균 10.4 ± 4.1 ng/mL이었다. 항뮐러관 호르몬 농도의범위에 따라 분류한 저(4-8 ng/mL), 중등(8-12 ng/mL), 고(＞12 ng/mL) 농도의 3군 간의 인슐린 저항성 관련 지표들은 차이가 없었다. 다낭성 난소증후군의 표현형에 따른 분류에서 항뮐러관 호르몬의 유의한 차이는 나타나지 않았으나, 체중, 체질량지수, 허리-둔부 둘레비,총 및 유리 테스토스테론, 성호르몬결합글로불린, 식후 2시간의 인슐린과 homeostasis model assessment of insulin resistance 지수는 다르게 나타났다. 총 테스토스테론과 초음파로 관찰한 난소 부피 및 난포 개수는 항뮐러관 호르몬과 양의 상관 관계가 있었다. 결론다낭성 난소증후군 환자에서 증가되어 있는 항뮐러관 호르몬 농도는 총 테스토스테론과 다낭성 난소 형태의 초음파 소견과 상관성이 있었다.

Abstract

Objective The aim of this study is to investigate the relationship between anti-Mlerian hormone (AMH) and parameters related to polycystic ovary syndrome (PCOS). Methods We measured serum AMH levels in 100 women with PCOS by Rotterdam European Society for Human Reproduction and Embryology criteria. We conducted somatometry, blood test and transvaginal or transrectal ultrasound test. We compared and analyzed AMH and parameters in terms of insulin resistance according to PCOS related phenotypes. We divided phenotypes into four groups by polycystic ovarian morphology (PCOM) and hyperandrogenemia (total testosterone [TT], free testosterone [fT]). Results AMH levels ranged from 4.1 to 21.0 ng/mL and the mean level was 10.4 4.1 ng/mL. Signifi cant differences in parameters of insulin resistance were not observed among low (4 to 8 ng/mL), moderate (8 to 12 ng/mL), and high (>12 ng/mL) levels of AMH. Significant differences in AMH were not observed among groups according to PCOS related phenotypes. Weight, body mass index, waist-hip ratio, TT, fT, sex hormone binding globulin, 2-hour insulin and homeostasis model assessment of insulin resistance index were different signifi cantly according to PCOS related phenotypes. TT, ovarian volume and follicle number were positively correlated with AMH. Conclusion Increased serum AMH levels in PCOS are correlated with TT and PCOM.

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