Anti-Mullerian hormone may be a useful adjunct in the diagnosis of polycystic ovary syndrome in nonobese adolescents

Objectives: This study aimed to [1] confirm that nonobese adolescents with polycystic ovary syndrome (PCOS) have higher anti-Mullerian hormone (AMH) than controls; [2] examine the relationship of AMH with PCOS features and hormonal profile; and [3] approximate an AMH value that discriminates between adolescents with PCOS and controls. Design: Case-control study. Setting: Subspecialty ambulatory clinic. Patients: Thirty-one nonobese adolescent girls (age 13-21 years), 15 with PCOS diagnosed using the National Institutes of Health (NIH) criteria and 16 healthy control subjects. Subjects and controls were comparable for body mass index z-score, age and ethnicity. Main outcome measure(s): AMH in PCOS subjects and control groups, correlation of AMH with hormonal parameters. Results: AMH was higher in PCOS subjects (4.4+/-3.4 ng/mL) than in controls (2.4+/-1.3 ng/mL), when adjusted for menstrual age. In the entire group (PCOS and controls), AMH correlated with androgens, ovarian size and the presence of polycystic ovary (PCO) appearance. There was no difference in average ovarian size between PCOS (7.1+/-2.6 cm(3)) and controls (6.7+/-1.8 cm(3)). PCOS subjects were 1.49 times more likely to have AMH >3.4 ng/mL (confidence interval 0.98-2.26 ng/mL). Conclusions: Our data suggest that AMH may be a useful adjunct in the diagnosis of PCOS in adolescents.