problendoПроблемы ЭндокринологииProblems of Endocrinology0375-96602308-1430Endocrinology Research Centre10.14341/probl201662456-59problendo-7892Research ArticleОбзорыReviewsРоль антимюллерового гормона в диагностике синдрома поликистозных яичников в подростковом возрасте (обзор литературы)The role of anti-Müllerian hormone in the diagnostics of polycystic ovary syndrome in adolescence (review)СоболеваЕлена ЛеонидовнаSobolevaElena L.

Доктор медицинских наук, профессор  кафедры акушерства и гинекологии

MD, PhD, Professor

doclena@inbox.ruhttps://orcid.org/0000-0001-9738-9881ВласоваЕлена СергеевнаVlasovaElena S.

Клинический ординатор кафедры акушерства и гинекологии

Resident

ElenaVlasova90@mail.ruЗазерскаяИрина ЕвгеньевнаZazerskayaIrina E.

Доктор медицинских наук, заместитель директора Института перинатологии и педиатрии по научной работе, заведующая кафедрой акушерства и гинекологии

MD, PhD

zazera@mail.ruФГБУ "Северо-Западный федеральный медицинский исследовательский центр имени В.А. Алмазова"РоссияFederal Almazov North-West Medical Research CentreRussian Federation2016100620166245659Copyright © Соболева Е.Л., Власова Е.С., Зазерская И.Е., 20162016Соболева Е.Л., Власова Е.С., Зазерская И.Е.Soboleva E.L., Vlasova E.S., Zazerskaya I.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.probl-endojournals.ru/jour/article/view/7892

Синдром поликистозных яичников (СПЯ) является наиболее частой причиной гиперандрогении у женщин. Критерии диагностики СПЯ у лиц репродуктивного возраста до настоящего времени являются предметом спора. Диагностика СПЯ у подростков сопряжена с еще бόльшими трудностями, так как многие его проявления присущи и нормальному пубертату. Все большее внимание уделяется поиску новых маркеров СПЯ у подростков, одним из которых может быть антимюллеров гормон. Однако данные о его диагностической ценности противоречивы, что требует проведения более масштабных исследований.

Polycystic ovary syndrome (PCOS) is the most common cause of hyperandrogenism in women. The criteria for diagnosis in women of reproductive age at present are subject to dispute. At the same time, diagnosis in adolescent girls is associated with even greater challenges, since many of the manifestations of the disease are a manifestation of normal puberty. In the absence of clear criteria for diagnosis in adolescence, more attention is paid to the search for new markers PCOS, one of which may be anti-Müllerian hormone. However, data on its diagnostic value is currently controversial, which calls for more extensive research in order to develop specific criteria for the diagnosis PCOS in teenagers.

синдром поликистозных яичниковгирсутизмдевочки-подросткиантимюллеровский гормонановуляцияpolycystic ovary syndromeadolescence girlsanti-müllerian hormonehirsutismanovulationReferencesConsensus on women’s health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril. 2012; 97(1):28-38.e2. doi: 10.1016/j.fertnstert.2011.09.024Consensus on women’s health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril. 2012; 97(1):28-38.e2. doi: 10.1016/j.fertnstert.2011.09.024Zawadzki JK, Dunaif A. Diagnostic criteria for polycystic ovary syndrome: towards a rational approach. In: Dunaif A, Givens JR, Haseltine FP, Merriam GR, eds. Polycystic ovary syndrome. Boston: Blackwell. 1992;377-384.Zawadzki JK, Dunaif A. Diagnostic criteria for polycystic ovary syndrome: towards a rational approach. In: Dunaif A, Givens JR, Haseltine FP, Merriam GR, eds. Polycystic ovary syndrome. Boston: Blackwell. 1992;377-384.The Rotterdam ESHRE/ASRM-Sponsored Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19-25. doi: 10.1016/j.fertnstert.2003.10.004The Rotterdam ESHRE/ASRM-Sponsored Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19-25. doi: 10.1016/j.fertnstert.2003.10.004Metcalf MG, Skidmore DS, Lowry GF, Mackenzie JA. Incidence of ovulation in the years after the menarche. J Endocrinol. 1983;97(2):213-219. doi: 10.1677/joe.0.0970213Metcalf MG, Skidmore DS, Lowry GF, Mackenzie JA. Incidence of ovulation in the years after the menarche. J Endocrinol. 1983;97(2):213-219. doi: 10.1677/joe.0.0970213Venturoli S, Porcu E, Fabbri R, et al. Menstrual irregularities in adolescents: hormonal pattern and ovarian morphology. Horm Res. 1986;24(4):269-279. doi: 10.1159/000180567Venturoli S, Porcu E, Fabbri R, et al. Menstrual irregularities in adolescents: hormonal pattern and ovarian morphology. Horm Res. 1986;24(4):269-279. doi: 10.1159/000180567van Hooff MH, Voorhorst FJ, Kaptein MB, et al. Predictive value of menstrual cycle pattern, body mass index, hormone levels and polycystic ovaries at age 15 years for oligo-amenorrhoea at age 18 years. Hum Reprod. 2004;19(2):383-392. doi: 10.1093/humrep/deh079van Hooff MH, Voorhorst FJ, Kaptein MB, et al. Predictive value of menstrual cycle pattern, body mass index, hormone levels and polycystic ovaries at age 15 years for oligo-amenorrhoea at age 18 years. Hum Reprod. 2004;19(2):383-392. doi: 10.1093/humrep/deh079Venturoli S, Porcu E, Fabbri R, et al. Longitudinal change of sonographic ovarian aspects and endocrine parameters in irregular cycles of adolescence. Pediatr Res. 1995;38(6):974-980. doi: 10.1203/00006450-199512000-00024Venturoli S, Porcu E, Fabbri R, et al. Longitudinal change of sonographic ovarian aspects and endocrine parameters in irregular cycles of adolescence. Pediatr Res. 1995;38(6):974-980. doi: 10.1203/00006450-199512000-00024Довженко Т.В., Ильина Н.А., Гродницкая Е.Э. Проблема психических нарушений при синдроме поликистозных яичников. // Социальная и клиническая психиатрия. — 2015. — Т. 25. — № 2. — С. 94-100. [ Dovzhenko TV, Ilyina NA, Grodnitskaya EE. Mental disorders in persons with polycystic ovary syndrome. Sotsial’naya i klinicheskaya psikhiatriya. 2015;25(2):94-100. (In Russ.)].Довженко Т.В., Ильина Н.А., Гродницкая Е.Э. Проблема психических нарушений при синдроме поликистозных яичников. // Социальная и клиническая психиатрия. — 2015. — Т. 25. — № 2. — С. 94-100. [ Dovzhenko TV, Ilyina NA, Grodnitskaya EE. Mental disorders in persons with polycystic ovary syndrome. Sotsial’naya i klinicheskaya psikhiatriya. 2015;25(2):94-100. (In Russ.)].Cate RL, Mattaliano RJ, Hession C, et al. Isolation of the bovine and human genes for Müllerian inhibiting substance and expression of the human gene in animal cells. Cell. 1986;45(5):685-698. doi.org/10.1016/0092-8674(86)90783-XCate RL, Mattaliano RJ, Hession C, et al. Isolation of the bovine and human genes for Müllerian inhibiting substance and expression of the human gene in animal cells. Cell. 1986;45(5):685-698. doi.org/10.1016/0092-8674(86)90783-XCohen-Haguenauer O, Picard JY, Mattéi MG, et al. Mapping of the gene for anti-Müllerian hormone to the short arm of human chromosome 19. Cytogenet. Cell Genet. 1987;44(1):2-6. doi: 10.1159/000132332Cohen-Haguenauer O, Picard JY, Mattéi MG, et al. Mapping of the gene for anti-Müllerian hormone to the short arm of human chromosome 19. Cytogenet. Cell Genet. 1987;44(1):2-6. doi: 10.1159/000132332Imbeaud S, Faure E, Lamarre I, et al. Insensitivity to anti-Müllerian hormone due to a mutation in the human anti-Müllerian hormone receptor. Nat Genet. 1995;11:382-388. doi: 10.1038/ng1295-382Imbeaud S, Faure E, Lamarre I, et al. Insensitivity to anti-Müllerian hormone due to a mutation in the human anti-Müllerian hormone receptor. Nat Genet. 1995;11:382-388. doi: 10.1038/ng1295-382Josso N, Clemente N. Transduction pathway of anti-Müllerian hormone, a sex-specific member of the TGF-β family. Trends Endocrinol Metab. 2003;14(2):91-97. doi: 10.1016/S1043-2760(03)00005-5Josso N, Clemente N. Transduction pathway of anti-Müllerian hormone, a sex-specific member of the TGF-β family. Trends Endocrinol Metab. 2003;14(2):91-97. doi: 10.1016/S1043-2760(03)00005-5Weenen C, Laven JS, von Bergh AR, et al. Anti-Müllerian hormone expression pattern in the human ovary: potential implications for initial and cyclic follicle recruitment. Mol Hum Reprod. 2004;10(2):77-83. doi: 10.1093/molehr/gah015Weenen C, Laven JS, von Bergh AR, et al. Anti-Müllerian hormone expression pattern in the human ovary: potential implications for initial and cyclic follicle recruitment. Mol Hum Reprod. 2004;10(2):77-83. doi: 10.1093/molehr/gah015Jeppesen JV, Anderson RA, Kelsey TW, et al. Which follicles make the most anti-Müllerian hormone in humans? Evidence for an abrupt decline in AMH production at the time of follicle selection. Mol Hum Reprod. 2013;19(8):519-527. doi: 10.1093/molehr/gat024Jeppesen JV, Anderson RA, Kelsey TW, et al. Which follicles make the most anti-Müllerian hormone in humans? Evidence for an abrupt decline in AMH production at the time of follicle selection. Mol Hum Reprod. 2013;19(8):519-527. doi: 10.1093/molehr/gat024Laven JS, Mulders AG, Visser JA, et al. Anti-Müllerian hormone serum concentrations in normoovulatory and anovulatory women of reproductive age. J Clin Endocrinol Metab. 2004;89(1):318-323. doi.org/10.1210/jc.2003-030932Laven JS, Mulders AG, Visser JA, et al. Anti-Müllerian hormone serum concentrations in normoovulatory and anovulatory women of reproductive age. J Clin Endocrinol Metab. 2004;89(1):318-323. doi.org/10.1210/jc.2003-030932Pellatt L, Hanna L, Brincat M, et al. Granulosa cell production of anti-Müllerian hormone is increased in polycystic ovaries. J Clin Endocrinol Metab. 2007;92(1):240-245. doi: 10.1210/jc.2006-1582Pellatt L, Hanna L, Brincat M, et al. Granulosa cell production of anti-Müllerian hormone is increased in polycystic ovaries. J Clin Endocrinol Metab. 2007;92(1):240-245. doi: 10.1210/jc.2006-1582Pigny P, Jonard S, Robert Y, Dewailly D. Serum anti-Mullerian hormone as a surrogate for antral follicle count for definition of the polycystic ovary syndrome. J Clin Endocrinol Metab. 2006;91(3):941-945. doi: 10.1210/jc.2005-2076Pigny P, Jonard S, Robert Y, Dewailly D. Serum anti-Mullerian hormone as a surrogate for antral follicle count for definition of the polycystic ovary syndrome. J Clin Endocrinol Metab. 2006;91(3):941-945. doi: 10.1210/jc.2005-2076Dewailly D, Gronier H, Poncelet E, et al. Diagnosis of polycystic ovary syndrome (PCOS): revisiting the threshold values of follicle count on ultrasound and of the serum AMH level for the definition of polycystic ovaries. Hum Reprod. 2011;26(11):3123-3129. doi: 10.1093/humrep/der297Dewailly D, Gronier H, Poncelet E, et al. Diagnosis of polycystic ovary syndrome (PCOS): revisiting the threshold values of follicle count on ultrasound and of the serum AMH level for the definition of polycystic ovaries. Hum Reprod. 2011;26(11):3123-3129. doi: 10.1093/humrep/der297Iliodromiti S, Kelsey TW, Anderson RA, Nelson SM. Can anti-Mullerian hormone predict the diagnosis of polycystic ovary syndrome? A systematic review and metaanalysis of extracted data. J Clin Endocrinol Metabol. 2013;98(8):3332-3340. doi: 10.1210/jc.2013-1393Iliodromiti S, Kelsey TW, Anderson RA, Nelson SM. Can anti-Mullerian hormone predict the diagnosis of polycystic ovary syndrome? A systematic review and metaanalysis of extracted data. J Clin Endocrinol Metabol. 2013;98(8):3332-3340. doi: 10.1210/jc.2013-1393Eilertsen TB, Vanky E, Carlsen SM. Anti-Mullerian hormone in the diagnosis of polycystic ovary syndrome: can morphologic description be replaced? Hum Reprod. 2012;27(8):2494-2502. doi: 10.1093/humrep/des213Eilertsen TB, Vanky E, Carlsen SM. Anti-Mullerian hormone in the diagnosis of polycystic ovary syndrome: can morphologic description be replaced? Hum Reprod. 2012;27(8):2494-2502. doi: 10.1093/humrep/des213Гродницкая Е.Э., Щербатюк Ю.В., Бендусов И.А., и др. Антимюллеров гормон как маркер синдрома поликистозных яичников.// Проблемы репродукции. — 2013. — №6. — С.27-30. [Grodnitskaia EE, Shcherbatiuk YuV, Bendusov IA, et al. Аnti-müllerian hormone as a diagnostic marker of polycystic ovary syndrome. Modern reproductive technologies. 2013;(6):27-30. (In Russ.)].Гродницкая Е.Э., Щербатюк Ю.В., Бендусов И.А., и др. Антимюллеров гормон как маркер синдрома поликистозных яичников.// Проблемы репродукции. — 2013. — №6. — С.27-30. [Grodnitskaia EE, Shcherbatiuk YuV, Bendusov IA, et al. Аnti-müllerian hormone as a diagnostic marker of polycystic ovary syndrome. Modern reproductive technologies. 2013;(6):27-30. (In Russ.)].Li L, Chen X, Mo Y, et al. Elevated serum anti-mullerian hormone in adolescent and young adult Chinese patients with polycystic ovary syndrome. Wien Klin Wochenschr. 2010;122(17):519-524. doi: 10.1007/s00508-010-1426-xLi L, Chen X, Mo Y, et al. Elevated serum anti-mullerian hormone in adolescent and young adult Chinese patients with polycystic ovary syndrome. Wien Klin Wochenschr. 2010;122(17):519-524. doi: 10.1007/s00508-010-1426-xHart R, Doherty DA, Norman RJ, et al. Serum anti-mullerian hormone (AMH) levels are elevated in adolescent girls with polycystic ovaries and the polycystic ovarian syndrome (PCOS). Fertil Steril. 2010;94(3):1118-1121. doi: 10.1016/j.fertnstert.2009.11.002Hart R, Doherty DA, Norman RJ, et al. Serum anti-mullerian hormone (AMH) levels are elevated in adolescent girls with polycystic ovaries and the polycystic ovarian syndrome (PCOS). Fertil Steril. 2010;94(3):1118-1121. doi: 10.1016/j.fertnstert.2009.11.002Piltonen T, Morin-Papunen L, Koivunen R, et al. Serum anti-Müllerian hormone levels remain high until late reproductive age and decrease during metformin therapy in women with polycystic ovary syndrome. Hum Reprod. 2005;20(7):1820-1826. doi: 10.1093/humrep/deh850Piltonen T, Morin-Papunen L, Koivunen R, et al. Serum anti-Müllerian hormone levels remain high until late reproductive age and decrease during metformin therapy in women with polycystic ovary syndrome. Hum Reprod. 2005;20(7):1820-1826. doi: 10.1093/humrep/deh850Nardo LG, Yates AP, Roberts SA, et al. The relationships between AMH, androgens, insulin resistance and basal ovarian follicular status in non-obese subfertile women with and without polycystic ovary syndrome. Hum Reprod. 2009;24(11):2917-2923. doi: 10.1093/humrep/dep225Nardo LG, Yates AP, Roberts SA, et al. The relationships between AMH, androgens, insulin resistance and basal ovarian follicular status in non-obese subfertile women with and without polycystic ovary syndrome. Hum Reprod. 2009;24(11):2917-2923. doi: 10.1093/humrep/dep225Carlsen SM, Vanky E, Fleming R. Anti-Müllerian hormone concentrations in androgen-suppressed women with polycystic ovary syndrome. Hum Reprod. 2009;24(7):1732-1738. doi: 10.1093/humrep/dep074Carlsen SM, Vanky E, Fleming R. Anti-Müllerian hormone concentrations in androgen-suppressed women with polycystic ovary syndrome. Hum Reprod. 2009;24(7):1732-1738. doi: 10.1093/humrep/dep074Piouka A, Farmakiotis D, Katsikis I, et al. Anti-Mullerian hormone levels reflect severity of PCOS but are negatively influenced by obesity: relationship with increased luteinizing hormone levels. Am J Phys Endocrinol Metab. 2009;296(2):E238-E243. doi: 10.1152/ajpendo.90684.2008Piouka A, Farmakiotis D, Katsikis I, et al. Anti-Mullerian hormone levels reflect severity of PCOS but are negatively influenced by obesity: relationship with increased luteinizing hormone levels. Am J Phys Endocrinol Metab. 2009;296(2):E238-E243. doi: 10.1152/ajpendo.90684.2008Pinola P, Morin-Papunen LC, Bloigu A, et al. Anti-Müllerian hormone: correlation with testosterone and oligo- or amenorrhoea in female adolescence in a population-based cohort study. Hum Reprod. 2014;29(10):2317-2325. doi: 10.1093/humrep/deu182Pinola P, Morin-Papunen LC, Bloigu A, et al. Anti-Müllerian hormone: correlation with testosterone and oligo- or amenorrhoea in female adolescence in a population-based cohort study. Hum Reprod. 2014;29(10):2317-2325. doi: 10.1093/humrep/deu182Cui L, Qin Y, Gao X, et al. Antimullerian hormone: correlation with age and androgenic and metabolic factors in women from birth to postmenopause. Fertil Steril. 2016;105(2):481-485e.1. doi: 10.1016/j.fertnstert.2015.10.017Cui L, Qin Y, Gao X, et al. Antimullerian hormone: correlation with age and androgenic and metabolic factors in women from birth to postmenopause. Fertil Steril. 2016;105(2):481-485e.1. doi: 10.1016/j.fertnstert.2015.10.017Cengiz H, Ekin M, Dagdeviren H, et al. Comparison of serum anti-Müllerian hormone levels in normal weight and overweight-obese adolescent patients with polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol. 2014;180:46-50. doi: 10.1016/j.ejogrb.2014.06.018Cengiz H, Ekin M, Dagdeviren H, et al. Comparison of serum anti-Müllerian hormone levels in normal weight and overweight-obese adolescent patients with polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol. 2014;180:46-50. doi: 10.1016/j.ejogrb.2014.06.018Pawelczak M, Kenigsberg L, Milla S, et al. Elevated serum anti-Müllerian hormone in adolescents with polycystic ovary syndrome: relationship to ultrasound features. J Pediatr Endocrinol Metab. 2012;25(9-10):983-989. doi: 10.1515/jpem-2012-0013Pawelczak M, Kenigsberg L, Milla S, et al. Elevated serum anti-Müllerian hormone in adolescents with polycystic ovary syndrome: relationship to ultrasound features. J Pediatr Endocrinol Metab. 2012;25(9-10):983-989. doi: 10.1515/jpem-2012-0013Siow Y, Kives S, Hertweck P, et al. Serum Müllerian-inhibiting substance levels in adolescent girls with normal menstrual cycles or with polycystic ovary syndrome. Fertil Steril. 2005;84(4):938-944. doi: 10.1016/j.fertnstert.2005.02.052Siow Y, Kives S, Hertweck P, et al. Serum Müllerian-inhibiting substance levels in adolescent girls with normal menstrual cycles or with polycystic ovary syndrome. Fertil Steril. 2005;84(4):938-944. doi: 10.1016/j.fertnstert.2005.02.052

The authors declare that there are no conflicts of interest present.