AMH联合卵巢超声影像学参数对早发性卵巢功能不全的预测价值OA北大核心CSTPCD

Objective To investigate the changes of sex hormones,anti-Müllerian hormone(AMH)level and ovarian ultrasound imaging parameters in women of childbearing age,so as to analyze their predictive value for premature ovarian insufficiency(POI)and establish the predictive model.Methods A total of 1 968 women of childbearing age in The First Affiliated Hospital of Xi'an Jiaotong University from 2018 to June 2022 were selected as research subjects.Their sex hormones and AMH levels were detected,and ultrasonographic features of the ovary were detected,including antral follicle count(AFC),ovarian volume,ovarian cortical volume,ovarian medulla volume,the total area,ovarian cortical area,and ovarian medulla area.The changes in ovarian function status at different age were analyzed,and their predictive value for POI was explored.AMH combined with ovarian ultrasound imaging parameters was used to establish a model for predicting POI.Results Among the 1 968 subjects,the prevalence rate of POI was 3.10％.The prevalence rate of POI was significantly higher in 30-39 years old group than in 20-29 years old group(P＜0.05).The serum AMH level in 30-34 years old group was significantly lower than that in 20-24 years old group and 25-29 years old group(P＜0.05),and the serum follicle stimulating hormone(FSH)and luteinizing hormone(LH)levels were significantly higher in 35-39 years old group than in 30-34 years old group(P＜0.05).The serum estradiol(E2)and AMH levels,AFC,ovarian volume,ovarian cortical volume,ovarian area,and ovarian cortical area were significantly lower than those in the 30-34 years old group(P＜0.05).The serum FSH and LH levels in POI group were significantly higher than women of the same age with normal ovarian function(P＜0.05),while the serum E2 and AMH levels were significantly lower than women of the same age with normal ovarian function(P＜0.05).The AFC,ovarian volume,ovarian cortical volume,ovarian medullary volume,ovarian area,ovarian cortical area,and ovarian medullary area in POI group were significantly lower than women of the same age with normal ovarian function(P＜0.05).The analysis results of the predictive value of hormone indicators for POI showed that AMH had the highest predictive value(AUC=0.957),followed by E2(AUC=0.840).Among the ultrasound imaging indicators,AFC had the largest predictive value(AUC=0.867),followed by ovarian cortical volume(AUC=0.835).The model established by AMH combined with ovarian ultrasound imaging parameters had a good predictive value for POI,and its sensitivity was 94.86％,specificity was 91.23％,AUC was 0.960,and the cutoff value was 12 points.Conclusion The prevalence of POI is high in women aged 30-39 years of reproductive age.The model established by AMH combined with ovarian ultrasound imaging parameters has certain predictive value for POI,especially for women in the occult stage,and thus deserves clinical attention.