Research question

To evaluate the correlation between clinical and hormonal parameters and comorbidity burden in Caucasian women presenting for fertility treatment.

Design

Monocentric cross-sectional study including a cohort of 3163 Caucasian women seeking medical care for fertility treatment. All patients underwent centralized laboratory testing for hormonal assessment. Complete clinical and laboratory data from the entire cohort were retrospectively analysed. Comorbidity burden score was assessed by the Charlson Comorbidity Index (CCI; categorized as 0 versus 1 versus ≥2).

Results

Descriptive statistics and regression models tested the associations between clinical and laboratory parameters and CCI. Among the entire cohort of patients, a CCI = 0 was found in 2977 women (94.1%), and CCI = 1 and CCI ≥2 were found in 113 (3.6%) and 73 (2.3%) patients, respectively. Age (P = 0.009), gravidity (P = 0.001), anti-Müllerian hormone (AMH, P < 0.001) and TSH (P = 0.003) values were significantly different among CCI groups. In regression models, age at presentation and AMH emerged as independent indicators of CCI ≥ 1. Age at presentation <36 years (odds ratio [OR] 1.742, 95% confidence interval [CI] 1.284–2.364) and an AMH concentration ≤2.3 ng/ml (OR 1.864, 95% CI 1.29–2.69) were the most informative cut-off values for CCI ≥ 1 in the study population.

Conclusions

A younger age at presentation and lower AMH concentrations are significant independent indicators of decreased general health in women requiring clinical evaluation for fertility treatment. As observed for sperm parameters in men, AMH might serve as a proxy of women's general health status.

中文翻译：

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抗苗勒管激素浓度作为女性总体健康状况的指标：一项横断面研究

研究问题

评估接受生育治疗的高加索女性的临床和激素参数与合并症负担之间的相关性。

设计

单中心横断面研究，包括一组 3163 名寻求生育治疗的高加索女性。所有患者都接受了集中实验室测试以进行激素评估。回顾性分析了整个队列的完整临床和实验室数据。合并症负担评分通过查尔森合并症指数（CCI；分类为 0 vs 1 vs ≥2）进行评估。

结果

描述性统计和回归模型测试了临床和实验室参数与 CCI 之间的关联。在整个患者队列中，2977 名女性 (94.1%) 发现 CCI = 0，分别在 113 (3.6%) 和 73 (2.3%) 名患者中发现 CCI = 1 和 CCI ≥2。年龄 ( P  = 0.009)、妊娠 ( P  = 0.001)、抗苗勒管激素 (AMH, P  < 0.001) 和 TSH ( P = 0.003) 值在 CCI 组之间存在显着差异。在回归模型中，就诊年龄和 AMH 成为 CCI ≥ 1 的独立指标。就诊年龄 <36 岁（优势比 [OR] 1.742，95% 置信区间 [CI] 1.284–2.364）和 AMH 浓度≤2.3 ng /ml (OR 1.864, 95% CI 1.29–2.69) 是研究人群中 CCI ≥ 1 的信息最丰富的截止值。

结论

就诊时年龄较小和 AMH 浓度较低是需要进行生育治疗临床评估的女性总体健康状况下降的重要独立指标。正如对男性精子参数所观察到的那样，AMH 可以作为女性总体健康状况的代表。