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Anti-mullerian hormone is associated with advanced glycosylated end products in lean women with polycystic ovary syndrome

Endocrine Section, First Department of Medicine, University of Athens Medical School, Mikras Asias 75, Goudi 115-27, Athens, Greece¹ Division of Endocrinology and Human Reproduction, Second Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, 119, Mitropoleos Street, 54622 Thessaloniki, Greece² Laboratory of Biological Chemistry, University of Athens Medical School, Mikras Asias 75, Goudi 115-27, Athens, Greece

(Correspondence should be addressed to E Diamanti-Kandarakis; Email: akandara{at}otenet.gr)

Objective: Oocyte maturation process characterizes polycystic ovary syndrome (PCOS). The mechanisms of this abnormality leading to chronic anovulation are under investigation. Advanced glycosylated end products (AGEs), a marker of oxidative stress linked with oocyte maturation are localized in granulosa cells and are increased in sera, in women with PCOS. The aim of this study was to investigate the relationship, whether there is an association between the anti-mullerian hormone (AMH), a hormone produced by granulosa cells and AGEs in ovulatory and anovulatory PCOS (PCOS-Anov), as well as in non-PCOS anovulatory (Non-PCOS Anov) women.

Design: Cross-sectional study.

Methods: Data from sixty women with PCOS (37 anovulatory and 23 regularly ovulating) were compared with eleven Non-PCOS Anov women and 25 normal women. In each subject biochemical, hormonal, and ultrasonographic parameters were studied.

Results: AMH values were statistically significantly higher in PCOS-Anov (7.63±3.12) in comparison with ovulatory PCOS (PCOS-Ov; 4.92±2.50), Non-PCOS Anov (3.66±1.4), and controls (4.02±1.27 ng/ml). AGEs demonstrated a similar pattern: 8.70±1.65 in PCOS-Anov, 7.43±1.79, PCOS-Ov, 5.21±0.09, Non-PCOS Anov, and 5.85±0.89 U/ml in controls (P<0.005 for all comparison respectively). Follicle number was significantly higher in PCOS-Anov in comparison with other groups. A significant positive correlation between AMH and AGEs was observed (r: 0.326, P<0.01), and with the estimated AMH/AGEs ratio to follicle number (r: 0.42, P: 0.0001) and the presence of anovulation.

Conclusions: These data suggest that an oxidative marker, AGEs, and AMH, may interact in the anovulatory mechanisms in women with PCOS.