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

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 n...

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Main Authors: Padala Ravi Kumar, Radha Krishna Telagareddy, Deepak Kumar Dash, Debasish Patro
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-12-01
Series:Journal of Human Reproductive Sciences
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Online Access:https://journals.lww.com/10.4103/jhrs.jhrs_152_24
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Summary: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-Müllerian 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%, n = 61) followed by phenotype B (28.6%, n = 52), phenotype D (23.9%, n = 44) and phenotype C (16.3%, n = 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.
ISSN:0974-1208
1998-4766