Evaluation of the usefulness of antymüllerian hormone and inhibin B as markers of ovarian activity in patients with Turner syndrome—preliminary results
Open accessAbstract
INTRODUCTION: Spontaneous puberty occurs in 30% of patients with Turner Syndrome. Its absence is an indication for hormone replacement therapy (HRT). No reliable markers of spontaneous puberty have been defined to date. AIM OF THE STUDY: To evaluate the usefulness of antymüllerian hormone (AMH) and inhibin B assessment in predicting ovarian function and spontaneous puberty in girls with TS. MATERIAL AND METHODS: The study included 35 TS patients treated with human recombinant growth hormone (rhGH). Gonadal axis function parameters (LH, FSH and estradiol) were evaluated at the age of physiological puberty (10-12 years, mean 10.5 years), before introduction of HRT. Ad-ditionally AMH and inhibin B levels were assessed. In follow up patients were divided into 2 groups: with (SP) and without (WP) spontaneous puberty. Spontaneous puberty was defined as Tanner stage 2 or higher breast development. RESULTS: WP patients were observed until the mean age of 16y. SP occurred in 16 patients (mean age 10 years). Patients with SP presented with significantly lower mean FSH level (1.14-91.1 mIU/ml, mean mIU/ml 24.5 vs. 7.7-196.4 mIU/ml, mean 66.5 mIU/ml, p = 0.002), higher mean estradiol (10.5-68.8 pg/ml, mean 28.4 pg/ml vs. 6.1-26.0 pg/ml, mean 14.9 pg/ml, p = 0.005), AMH (0.0-3.11 ng/ml, mean 0.8 ng/ml vs. 0.0-0.002 ng/ml, mean 0.003 ng/ml, p = 0.001) and inhibin B (0.0-110.0 pg/ml, mean 29.1 pg/ml vs. 0.0-11.0 pg/ml, mean 1.06 pg/ml, p = 0.026) levels. In three SP patients without elevated FSH level (FSH < 35 mIU/ml) we found zero concen-tration levels of AMH and inhibin B. SP patients had mosaic (non 45,X) karyotype in 87.5% and WP patients only in 47%. CONCLUSIONS: AMH and inhibin B assessment may be a valuable complement to the diagnosis of ovarian function in patients with TS. Low levels of these parameters may indicate a risk of ovarian failure even in patients with spontaneous puberty and without hypergonadotropic hy-pogonadism.
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Low AMH and undetectable inhibin B can be used to predict ovarian insufficiency in Turner syndrome.
“Low AMH and undetectable inhibin B can also be used to predict ovarian insufficiency in TS”
From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [271]
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“Besides spontaneous menarche, in adult TS patients, AMH is a sensitive biomarker of ovarian reserve, in that the decline in serum AMH pre-cedes the changes in other predictors (Rusza ł a et al., 2020).”
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- Authors
- Ruszała, A., Wójcik, M., & Starzyk, J.
- Affiliations
- Jagiellonian University (PL)
- Venue
- Pediatric Endocrinology Diabetes and Metabolism
- Publisher
- Termedia Sp. z.o.o.
- Published
- 2020
- Volume
- 26
- Issue
- 2
- Pages
- 84-88
- ISSN
- 1234-625X (ISSN-L)
- 2081-237X
- OpenAlex
- W3032622233
- Cited by
- 10
- References
- 33
- Citations by year
- 2026: 3 · 2024: 3 · 2023: 2 · 2022: 2
- FWCI
- 0.59
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by-nc-sa
- Locations
- Pediatric Endocrinology Diabetes and Metabolism (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- Jagiellonian University Repository (Jagiellonian University) (submittedVersion, cc-by-nc-nd)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic and Clinical Aspects of Sex Determination and Chromosomal Abnormalities
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Sexual Differentiation and Disorders
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Keywords
- Turner syndrome, anti-Müllerian hormone, inhibin B, spontaneous puberty, ovarian function, ovarian reserve markers, follicle-stimulating hormone, estradiol, hormone replacement therapy, gonadal axis
- MeSH terms
- Child, Female, Humans, Inhibins, Ovary, Puberty, Turner Syndrome, Biomarkers, Anti-Mullerian Hormone, Karyotype
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