Anti-Müllerian hormone as a biomarker of ovarian function and spontaneous puberty in Turner syndrome: a systematic review.

IF 4.6 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Frontiers in Endocrinology Pub Date : 2025-09-15 eCollection Date: 2025-01-01 DOI:10.3389/fendo.2025.1640583

Bassam Bin-Abbas, Mosleh Jabari

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引用次数: 0

Abstract

Background: Turner syndrome (TS), caused by complete or partial X chromosome monosomy, often leads to primary ovarian insufficiency (POI) and pubertal delay. Anti-Müllerian hormone (AMH) is a key biomarker of ovarian reserve, but its predictive role in spontaneous puberty and ovarian function in TS remains unclear.

Methods: This systematic review followed PRISMA guidelines and included studies from PubMed, Embase, and Cochrane (2000-2025). Nine studies (865 TS patients, 976 controls) were analyzed. Outcomes included AMH levels in TS versus controls, association with spontaneous puberty, and predictive value for fertility preservation. Risk of bias was assessed using the Newcastle-Ottawa Scale.

Results: TS patients had significantly lower AMH levels than controls (weighted mean differences (WMD): -3.04 ng/mL, 95% CI: -3.26 to -2.83, p < 0.001). Detectable AMH correlated with spontaneous puberty (OR=5.12, 95% CI: 2.87-9.12), particularly in mosaic karyotypes. Subgroup analyses revealed assay variability, with ELISA-based methods detecting low but clinically relevant AMH levels. Sensitivity analyses confirmed robustness, and publication bias was minimal (Egger's p = 0.283).

Conclusion: AMH is a reliable biomarker for ovarian reserve and spontaneous puberty prediction in TS. Its integration into clinical practice may improve fertility counseling and hormone therapy timing. However, standardized assays and prospective studies are needed to optimize its diagnostic accuracy.

Systematic review registration: https://www.crd.york.ac.uk/prospero/ PROSPERO, identifier CRD420251051633.

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抗勒氏激素作为特纳综合征卵巢功能和自发性青春期的生物标志物：系统综述。

背景：特纳综合征（Turner syndrome， TS）是由完全或部分X染色体单体引起的，常导致原发性卵巢功能不全（POI）和青春期延迟。抗勒氏激素（AMH）是卵巢储备的关键生物标志物，但其在TS患者自发性青春期和卵巢功能中的预测作用尚不清楚。方法：本系统综述遵循PRISMA指南，纳入了PubMed、Embase和Cochrane（2000-2025）的研究。9项研究（865例TS患者，976例对照）进行了分析。结果包括TS组与对照组的AMH水平，与自发性青春期的关联，以及对生育能力保存的预测价值。偏倚风险采用纽卡斯尔-渥太华量表进行评估。结果：TS患者AMH水平显著低于对照组（加权平均差异（WMD）： -3.04 ng/mL, 95% CI: -3.26 ~ -2.83, p < 0.001）。可检测到的AMH与自发性青春期相关（OR=5.12, 95% CI: 2.87-9.12），特别是在镶嵌核型中。亚组分析揭示了检测的可变性，基于elisa的方法检测低但临床相关的AMH水平。敏感性分析证实了稳健性，发表偏倚最小（Egger’s p = 0.283）。结论：AMH是TS患者卵巢储备和青春期自发预测的可靠生物标志物，将其纳入临床实践可改善生育咨询和激素治疗时机。然而，需要标准化的分析和前瞻性研究来优化其诊断准确性。系统评价注册：https://www.crd.york.ac.uk/prospero/ PROSPERO，标识符CRD420251051633。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Endocrinology Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

5.70

自引率

9.60%

发文量

3023

审稿时长

14 weeks

期刊介绍： Frontiers in Endocrinology is a field journal of the "Frontiers in" journal series. In today’s world, endocrinology is becoming increasingly important as it underlies many of the challenges societies face - from obesity and diabetes to reproduction, population control and aging. Endocrinology covers a broad field from basic molecular and cellular communication through to clinical care and some of the most crucial public health issues. The journal, thus, welcomes outstanding contributions in any domain of endocrinology. Frontiers in Endocrinology publishes articles on the most outstanding discoveries across a wide research spectrum of Endocrinology. The mission of Frontiers in Endocrinology is to bring all relevant Endocrinology areas together on a single platform.