Age-group-specific reference intervals for anti-Mullerian hormone and its diagnostic performance for polycystic ovary syndrome in a Korean population

Abstract

Background We established age-group-specific reference intervals for serum anti-Mullerian hormone (AMH) levels in a Korean population and investigated the effectiveness of AMH assay for polycystic ovary syndrome (PCOS) diagnosis. Methods We analyzed serum levels of AMH, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) from 1540 Korean women. Subjects were divided into three groups: healthy, benign gynecologic diseases, and PCOS. Age-group-specific reference intervals and AMH diagnostic performance were estimated. Results The PCOS group had a median AMH level of 7.0 mu g/L, which was higher than for the healthy (1.8 mu g/L) and the benign gynecologic diseases (2.7 mu g/L) groups. The upper 97.5% reference limits for age groups 12-20 years, 21-34 years, and 35-46 years were 13.2 mu g/L, 15.8 mu g/L, and 6.6 mu g/L, respectively. The area under the curve (AUC) values to estimate AMH ability to discriminate PCOS from healthy women for each age group were 0.741, 0.785, and 0.789, respectively. AUCs for LH/FSH were 0.719, 0.672, and 0.590. Conclusions The better diagnostic ability of AMH over LH/FSH in women of late childbearing ages indicates that age and other clinical characteristics should be considered when interpreting these test results.