Diagnostic Utility of Various Hormones across Different Polycystic Ovary Syndrome Phenotypes: A Cross-sectional Study.

Padala Ravi Kumar, Radha Krishna Telagareddy, Deepak Kumar Dash, Debasish Patro
Author Information
  1. Padala Ravi Kumar: Department of Endocrinology, M.K.C.G Medical College, Berhampur, Odisha, India.
  2. Radha Krishna Telagareddy: Department of Endocrinology, RK ENDOCARE, Rajahmundry, Andhra Pradesh, India.
  3. Deepak Kumar Dash: Department of Endocrinology, M.K.C.G Medical College, Berhampur, Odisha, India.
  4. Debasish Patro: Department of Endocrinology, M.K.C.G Medical College, Berhampur, Odisha, India.

Abstract

Background: Polycystic ovary syndrome (PCOS) presents a complex diagnostic challenge due to its heterogeneous nature.
Aim: This study aimed to examine the diagnostic utility of various hormones across different PCOS phenotypes.
Settings and Design: This cross-sectional study was carried out in 187 newly diagnosed PCOS women (18-40 years) attending the outdoor clinics of the department of endocrinology and obstetrics and gynaecology of a tertiary care centre in India.
Materials and Methods: One hundred and eighty-seven PCOS women based on revised Rotterdam 2003 criteria were recruited. Ninety-four age-matched healthy females were taken as controls. All PCOS women were categorised into four phenotypes (A, B, C and D) based on the National Institute of Health (2012) criteria. Detailed clinical examination and hormonal investigations including testosterone, androstenedione, dehydroepiandrosterone sulphate (DHEAS) and anti-M��llerian hormone (AMH) were performed.
Statistical Analysis Used: The receiver operating characteristic curve (ROC) was generated to find the diagnostic utility of various hormones by using SPSS version 26.0 software.
Results: The largest PCOS group was phenotype A (33.15%, = 61) followed by phenotype B (28.6%, = 52), phenotype D (23.9%, = 44) and phenotype C (16.3%, = 30). In ROC analysis, AMH and testosterone (except phenotype D) were good diagnostic parameters for PCOS. AMH cutoffs varied from 4.4 to 5.6 ng/mL with sensitivities and specificities ranging from 86% to 97% and 85% to 100%, respectively, across all PCOS phenotypes. In the entire PCOS cohort, AMH at an optimal cutoff of 5.28 ng/mL had sensitivity and specificity of 87% and 97%, respectively, for the diagnosis of PCOS. Optimal testosterone cutoffs were 29.3, 25.1 and 23.1 ng/dL for phenotypes A, B and C, respectively, with reasonable sensitivities and specificities but not in phenotype D. Luteinising hormone (LH), follicle-stimulating hormone (FSH), LH/FSH ratio, androstenedione and DHEAS had low-to-moderate sensitivity across all phenotypes.
Conclusion: AMH is a useful hormonal diagnostic marker for PCOS across all phenotypes.

Keywords

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Word Cloud

Created with Highcharts 10.0.0PCOSphenotypesphenotypediagnosticacrossAMHDtestosteronehormone=womenBCrespectivelyPolycysticovarysyndromestudyutilityvarioushormonesbasedcriteriahormonalandrostenedioneDHEASROC2823cutoffs45ng/mLsensitivitiesspecificities97%sensitivity1Background:presentscomplexchallengedueheterogeneousnatureAim:aimedexaminedifferentSettingsDesign:cross-sectionalcarried187newlydiagnosed18-40yearsattendingoutdoorclinicsdepartmentendocrinologyobstetricsgynaecologytertiarycarecentreIndiaMaterialsMethods:Onehundredeighty-sevenrevisedRotterdam2003recruitedNinety-fourage-matchedhealthyfemalestakencontrolscategorisedfourNationalInstituteHealth2012Detailedclinicalexaminationinvestigationsincludingdehydroepiandrosteronesulphateanti-M��llerianperformedStatisticalAnalysisUsed:receiveroperatingcharacteristiccurvegeneratedfindusingSPSSversion260softwareResults:largestgroup3315%61followed6%529%44163%30analysisexceptgoodparametersvaried6ranging86%85%100%entirecohortoptimalcutoffspecificity87%diagnosisOptimal29325ng/dLreasonableLuteinisingLHfollicle-stimulatingFSHLH/FSHratiolow-to-moderateConclusion:usefulmarkerDiagnosticUtilityVariousHormonesDifferentOvarySyndromePhenotypes:Cross-sectionalStudyAnti-M��llerianpolycystic

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