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Submitted on February 6, 2007
Accepted on April 27, 2007
Endocrinology and Metabolism Laboratory, West Division, School of Medicine, University of Chile. Institute of Maternal and Child Research, School of Medicine, University of Chile
* To whom correspondence should be addressed. E-mail: tsir{at}med.uchile.cl.
CONTEXT: We have previously observed increased AMH levels in prepubertal daughters of PCOS women, suggesting that these girls may have an altered follicular development. However, it is not known whether AMH levels remain increased during puberty.
OBJECTIVE: To establish whether the increased AMH levels observed in prepubertal daughters of PCOS women persist during the peri-pubertal period, a stage during which the gonadal axis is activated and PCOS may become clinically manifested.
DESIGN: We studied 28 daughters (8 to 16 years old) of PCOS women (PCOSd) and 33 daughters (8 to 16 years old) of control women (Cd). In both groups an oral glucose tolerance test was performed. Gonadotropins, sex hormones and AMH were determined in a fasting sample.
RESULTS: Both groups were comparable in age, BMI and breast Tanner stage. Free androgen index (FAI), testosterone, AMH (Cd: 14.4 ± 8.0 pM vs PCOSd: 24.0 ± 19.0 pM; p= 0.012) and two hour insulin levels were significantly higher in the PCOSd group compared to the control group. The average ovarian volume was significantly higher in the PCOSd group. In both groups a positive correlation between 2h insulin and AMH concentrations was observed (PCOSd r = 0.530, p= 0.007; Cd r =0.561, p=0.008).
CONCLUSIONS: AMH concentrations are increased in peri-pubertal daughters of PCOS women. These findings, along with the results of our previous study, suggest that PCOS daughters appear to show an increased follicular mass which is established during early development, and persists during puberty.
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