OBJECTIVE To examine whether accounting for a woman's age and body mass index (BMI) would improve the ability of anti-Müllerian hormone (AMH) to distinguish between women with (cases) and without (controls) polycystic ovarian syndrome (PCOS). DESIGN An opportunistic case-control dataset of reproductive age women having evaluations for PCOS as defined by National Institutes of Health criteria. SETTING Two medical centers in the United States enrolled women. Serum samples were analyzed for relevant analytes. PATIENTS Women were between 18 and 39 years of age when samples and clinical information were collected. Residual samples had been stored for 2-17 years. AMH was measured via immunoassay. INTERVENTIONS None; this was an observational study. MAIN OUTCOME MEASURES Detection and false-positive rates for PCOS were computed for AMH results expressed as multiples of the median (MoM) both before and after adjustment for the woman's age and BMI. RESULTS Using unadjusted AMH MoM results, 168 cases (78%) cases were at or beyond the 90th centile of controls (2.47 MoM). After accounting for each woman's age and BMI, 188 (87%) of those women were beyond the 90th centile of controls (2.20 MoM), a significant increase (P = .015). The adjusted AMH MoM levels fitted logarithmic normal distributions well (mean, standard deviation for controls and cases of 0.0000, 0.2765 and 0.6884, 0.2874, respectively) and this allowed for computation of patient-specific PCOS risks. CONCLUSIONS Accounting for the woman's age and BMI resulted in significantly higher AMH-based detection rates for PCOS at a 10% false-positive rate, and patient-specific PCOS risks could be computed.

中文翻译：

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根据年龄和体重指数调整抗苗勒管激素水平可改善多囊卵巢综合征的检测

目的检查考虑女性的年龄和体重指数 (BMI) 是否会提高抗苗勒管激素 (AMH) 区分患有（病例）和不患有（对照）多囊卵巢综合征 (PCOS) 女性的能力。设计 根据美国国立卫生研究院标准，对多囊卵巢综合征进行评估的育龄妇女的机会性病例对照数据集。设置 美国的两个医疗中心招募了女性。分析血清样品的相关分析物。患者 收集样本和临床信息时，女性年龄在 18 至 39 岁之间。残留样品已储存 2-17 年。AMH通过免疫测定法测量。干预 无；这是一项观察性研究。主要观察指标 计算 AMH 结果的 PCOS 检出率和假阳性率，该结果表示为调整女性年龄和 BMI 前后的中位数 (MoM) 的倍数。结果 使用未经调整的 AMH MoM 结果，168 例 (78%) 病例处于或超过对照的第 90 个百分位 (2.47 MoM)。在考虑到每位女性的年龄和 BMI 后，其中 188 (87%) 名女性超出了对照组的第 90 个百分位 (2.20 MoM)，显着增加 (P = .015)。调整后的 AMH MoM 水平很好地拟合了对数正态分布（对照组和病例的平均值、标准偏差分别为 0.0000、0.2765 和 0.6884、0.2874），这允许计算患者特定的 PCOS 风险。结论 占女人的