Study on the distribution of serum AMH and its correlation with basal follicle stimulating hormone in 427 women of different ages
427例不同年龄阶段体检女性血清AMH分布特点及与基础卵泡刺激素的相关性研究

摘要

目的 研究本机构常规妇科体检女性血清抗缪勒氏管激素（AMH）的年龄特异性分布，并探讨不同年龄段AMH与基础卵泡刺激素（FSH）水平的关系。方法 选择2020年6月－2022年6月就诊于湖南省人民医院（湖南师范大学附属第一医院）妇产科门诊的427例常规妇科体检女性为研究对象，年龄在18-55岁，按年龄分为6组：18-25岁 组（77例），26-30岁组（68例），31-35岁组（53例），36-40岁组（70例），41-45岁组（83例），＞45岁组（76例）。应用iFlash3000化学发光测定仪测定血清中AMH、FSH水平，分析AMH的年龄特异性分布及AMH与FSH相互间的关系。结果 1、本机构427例常规妇科体检的女性血清AMH水平随年龄增长逐渐下降，18-25岁组血清AMH水平最高，在35岁后血清AMH水平开始明显下降，50岁后血清AMH水平处于较低水平；血清FSH水平随年龄增长逐渐升高，在40岁后升高趋势明显（ P＜0.001) ; 2、各组血清AMH水平与年龄均呈负相关（Ｐ＜0.01）；36-40岁组，41-45岁组、45岁组血清AMH水平与FSH水平呈负相关，相关系数分别为－0.19、-0.70、-0.41（Ｐ＜0.05），18-25 岁组、26- 30岁组、31-35岁组血清AMH水平与FSH水平表现为负相关趋势，但差异无统计学意义。结论 本机构427例常规妇科体检的女性血清AMH水平随年龄增加而下降，在35岁时开始明显下降，50岁后处于较低水平；血清AMH水平下降（35岁后开始）比FSH（40岁后开始）更早反映女性卵巢储备能力的下降；血清AMH水平与血清FSH水平在高龄女性（>35岁）存在负相关性。AMH、FSH这两个指标均可用于反映卵巢储备功能，临床上可结合AMH及FSH来预判卵巢储备，为临床工作提供指导意见。

Abstract

Objective To study the age-specific distribution of anti-Mullerian hormone (AMH) in women undergoing routine gynecological examination in our institution, and to explore the relationship between AMH and follicle stimulating hormone (FSH) levels in different age groups.
Methods A total of 427 women undergoing routine gynecological examination who visited the department of Obstetrics and Gynecology outpatient department of Hunan Provincial People's Hospital from June 2020 to June 2022 were selected as the subjects. They were divided into 6 groups by age: 18-25 years old group (77 cases), 26-30 years old group (68 cases), 31-35 years old group (53 cases), 36-40 years old group (70 cases), 41-45 years old group (83 cases), > 45 years old group (76 cases). The levels of AMH and FSH in serum were determined by iFlash3000 chemiluminescence analyzer, and the changes of AMH with age and the age-specific distribution of AMH and the relationship between AMH and FSH in these groups were analyzed.
Results 1. The serum AMH level of 427 women undergoing routine gynecological examination in our institution decreased gradually with the increase of age, and the highest level was found in 18-25 years old group.The serum AMH level began to decrease significantly after 35 years old, and remained at a low level after 50 years old.Serum FSH level gradually increased with age, and increased significantly after 40 years old (P < 0.001). 2. Serum AMH level was negatively correlated with age in all groups (P < 0.01). 36-40 years old group, 41-45 years old group, & GT; There was a negative correlation between serum AMH level and FSH level in the 45-year-old group, with correlation coefficients of -0.19, -0.70 and -0.41 (P < 0.05), and there was a negative correlation between serum AMH level and FSH level in the 18-25 years old group, 26-30 years old group and 31-35 years old group, but there was no statistical significance.
Conclusion   Serum AMH levels in 427 women undergoing routine gynecological examination in our institution decreased with age, and began to decrease significantly after 35 years old, and remained at a lower level after 50 years old;The decline of AMH (after 35 years old) reflects the decline of ovarian reserve earlier than FSH (after 40 years old);.There was a negative correlation between Serum AMH levels and serum FSH levels in older women (>35 years old) Both AMH and FSH can be used to reflect ovarian reserve function, which can be combined with AMH and FSH to predict ovarian reserve in clinical practice and provide guidance for clinical work.