Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists | 2019
DIAGNOSTIC VALUE OF ANTI-MÜLLERIAN HORMONE AS A BIOMARKER FOR POLYCYSTIC OVARY SYNDROME: A META-ANALYSIS UPDATE.
Abstract
Abstract Objective: A previous meta-analysis about the predictive ability of anti-Müllerian hormone (AMH) for polycystic ovary syndrome (PCOS) showed that independent AMH may be a useful initial diagnostic test for PCOS. The aims of this study were to update the meta-analysis and evaluate the diagnostic efficacy of AMH when it replaces polycystic ovary morphology (PCOM) in Rotterdam criteria.\n\n\nMETHODS\nTwo independent reviewers searched PubMed, Cochrane Library and Web of Science databases systematically to identify relevant articles by using the key words Anti-Müllerian Hormone and Polycystic Ovary Syndrome . The deadline for manuscript inclusion was July 31, 2018. A random-effects model was used and subgroup analysis and meta regression were performed to identify possible sources of heterogeneity. The methodological quality of each study was assessed by QUADAS-2 and funnel plot asymmetry test.\n\n\nRESULTS\nAccording to the inclusion criteria, 29 studies were included in this meta-analysis. The pooled sensitivity, specificity and diagnostic odds ratio (DOR) for AMH alone detecting PCOS were 0.76 (95%CI 0.71-0.81), 0.86 (95%CI 0.82-0.90) and 20 (95%CI 12-33). When AMH replaces PCOM for the diagnosis of PCOS, the pooled sensitivity, specificity and diagnostic odds ratio (DOR) rose to 0.93 (95%CI 0.89-0.96), 0.99 (95%CI 0.95-1.00), and 1634 (95%CI 217-12324), respectively. The area under the SROC curve (AUC) for AMH alone and AMH replacing PCOM detecting PCOS were 0.88(95%CI 0.85-0.91) and 0.97 (95%CI 0.95-0.98), respectively, which was significantly different (Z=4.89, P <0.01).\n\n\nCONCLUSION\nWhen AMH replaces polycystic ovary morphology (PCOM) in Rotterdam criteria, the diagnostic efficacy for polycystic ovary syndrome is better.