Anti-müllerian hormone and insulin-like 3 levels in healthy normal-weight ovulatory and anovulatory eumenorrheic late adolescent females: potential early biomarkers of ovarian dysfunction?

Eur J Obstet Gynecol Reprod Biol. 2015 Dec:195:188-192. doi: 10.1016/j.ejogrb.2015.09.045. Epub 2015 Oct 30.

Abstract

Objective: The aim of this study was to evaluate differences in anti-müllerian hormone (AMH) and insulin-like 3 (INSL3) levels and their association with gonadotropin and ovarian steroid hormones, as expression of ovarian function, between healthy normal-weight ovulatory and anovulatory eumenorrheic late adolescent females.

Study design: This study analyzed AMH and INSL3 levels in forty healthy eumenorrheic late adolescent females (aged 16-19 ys), selected from a cross-sectional epidemiological study performed on the prevalence of hyperandrogenic states. The subjects were divided into ovulatory (n: 28) and anovulatory (n: 12) groups in accordance to a previous cluster analysis based on progesterone (P) distribution measured once in the latter part of the cycle. Both groups were compared for anthropometric, biochemical and hormonal parameters.

Results: INSL3 and AMH were detectable in all samples. Testosterone (P=0.01), the free-androgen index (FAI) (P=0.051), gonadotropins (LH: P=0.02; FSH: P=0.004) and AMH (P=0.02) levels were significantly higher in the anovulatory group with respect to their ovulatory counterpart. A trend toward significantly higher INSL3 concentrations (P=0.08) was also shown in the anovulatory group. A positive correlation between INSL3 levels and androgens such as androstenedione (r=0.38; P=0.02), testosterone (r=0.44; P=0.004) and FAI (r=0.42; P=0.006) and a negative borderline significant correlation (r=-0.30; P=0.055) between AMH and P were shown in all subjects.

Conclusion: Healthy eumenorrheic late adolescent females with sporadic anovulation display higher AMH and INSL-3 blood concentrations in association with higher androgen levels compared with age- and BMI-matched subjects with ovulatory cycle, suggesting evidence of an earlier ovarian dysfunction.

Keywords: AMH; Adolescent females; Androgen; Anovulation; INSL3.

MeSH terms

  • 17-alpha-Hydroxyprogesterone / blood
  • Adolescent
  • Androstenedione / blood
  • Anovulation / blood*
  • Anti-Mullerian Hormone / blood*
  • Case-Control Studies
  • Chromatography, Liquid
  • Cross-Sectional Studies
  • Dehydroepiandrosterone / blood
  • Estradiol / blood
  • Female
  • Follicle Stimulating Hormone / blood
  • Humans
  • Insulin / blood*
  • Luteinizing Hormone / blood
  • Progesterone / blood
  • Proteins
  • Radioimmunoassay
  • Sex Hormone-Binding Globulin / metabolism
  • Tandem Mass Spectrometry
  • Testosterone
  • Young Adult

Substances

  • Insulin
  • Leydig insulin-like protein
  • Proteins
  • Sex Hormone-Binding Globulin
  • Testosterone
  • Androstenedione
  • Dehydroepiandrosterone
  • Progesterone
  • Estradiol
  • 17-alpha-Hydroxyprogesterone
  • Anti-Mullerian Hormone
  • Luteinizing Hormone
  • Follicle Stimulating Hormone