ABSTRACT
Objective:To investigate the correlation between the level of anti Mullerian hormone (AMH) in serum and ovarian interstitial blood flow in patients with polycystic ovary syndrome (PCOS).Methods:The clinical data of 88 patients with PCOS (PCOS group) admitted to Jiangshan Hospital of Traditional Chinese Medicine from June 2019 to June 2022 and 50 women of the same age who underwent physical examination during the same period (normal control group) were collected retrospectively. The patients in the PCOS group were divided into two subgroups according to the homeostatic model assessment for insulin resistance index (HOMA-IR) evaluated by the steady-state model. Among them, patients with HOMA-IR ≥ 2.69 were divided into the insulin resistance subgroup (PCOS-IR subgroup, 50 cases), and patients with HOMA-IR<2.69 were divided into the non-insulin resistance subgroup (PCOS-NIR subgroup, 38 cases). The level of AMH were measured by electrochemiluminescence, and ovarian interstitial blood flow indicators, including peak blood flow velocity (PSV), pulsation index (PI), and resistance index (RI) were monitored. Pearson correlation test was used to analyze the correlation between serum AMH and insulin resistance and ovarian interstitial blood flow. Meanwhile, Logistic linear regression model was used to analyze the influencing factors of ovarian interstitial blood flow in patients with PCOS.Results:The levels of AMH, HOMA-IR and PSV in the PCOS group were higher than those in the normal control group: (2.13 ± 0.84) μg/L vs. (0.84 ± 0.29) μg/L, 4.6(2.0, 8.4) vs. 1.8(0.5, 3.9), (10.05 ± 1.52) cm/s vs.(6.78 ± 0.89) cm/s; the PI and RI in the PCOS group were lower than those in the control group: (1.14 ± 0.26)% vs. (2.01 ± 0.53)%, (0.37 ± 0.18)% vs. (0.85 ± 0.33)%, there were statistical differences ( P<0.05). The levels of AMH, HOMA-IR and PSV in the PCOS-IR subgroup were higher than those in the PCOS-NIR subgroup: (2.68 ± 0.81) μg/L vs. (1.59 ± 0.43) μg/L, (10.74 ± 2.32) cm/s vs. (7.93 ± 1.90) cm/s, 7.2(3.1, 15.8) vs. 2.1(0.6, 5.3); the PI and RI in the PCOS-IR subgroup were lower than those in the PCOS-NIR subgroup: (0.88 ± 0.35)% vs. (1.52 ± 0.50)%, (0.29 ± 0.04)% vs. (0.51 ± 0.05)%, there were statistical differences ( P<0.05). Pearson correlation analysis showed that the level of AMH were positively correlated with PSV and HOMA-IR ( r = 0.694 and 0.540, P<0.05), but negatively correlated with PI and RI( r = - 0.687 and - 0.692, P<0.05). Logistic linear regression model analysis showed that AMH and HOMA-IR were risk factors for ovarian interstitial blood flow in patients with PCOS( P<0.05). Conclusions:The serum AMH level in patients with PCOS is abnormally high and increases with insulin resistance. At the same time, the imbalance of AMH expression plays an important role in the increase of abnormal ovarian interstitial blood flow.