Age-specific cut-off levels of anti-Müllerian hormone can be
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Utilization of age-specific cut-off levels of anti-Müllerian hormone (AMH) could help assess the value of AMH in discriminating PCOS patients in all age categories.

The majority of available studies on the AMH thresholds were not age-specific and performed the receiver operating characteristic curve (ROC) analysis, based on variations in sensitivity and specificity rather than positive and negative predictive values (PPV and NPV, respectively), which are more clinically applicable.

A total of 803 women, including 303 PCOS patients and 500 eumenorrheic non-hirsute control women, were enrolled in the present study. The PCOS group included PCOS women, aged 20–40 years. The Rotterdam consensus criteria were used for the diagnosis of PCOS. The control group was selected among women, aged 20–40 years. Generalized additive models (GAMs) were used to identify the optimal cut-off points for various age categories. The cut-off levels of AMH in different age categories were estimated, using the Bayesian method.

--Two optimal cut-off levels of AMH (ng/ml) were identified at the age of 27 and 35 years, based on GAMs.

--The cut-off levels for the prediction of PCOS in the age categories of 20–27, 27–35, and 35–40 years were 5.7, 4.55, and 3.72, respectively.

--Based on the Bayesian method, the PPV and NPV of these cut-off levels were as follows: PPV?=?0.98 and NPV?=?0.40 for the age group of 20–27 years; PPV?=?0.96 and NPV?=?0.82 for the age group of 27–35 years; and PPV?=?0.86 and NPV?=?0.96 for the age group of 35–40 years.

In summary, the application of age-specific cut-off levels of AMH, according to the GAMs and Bayesian method, could elegantly assess the value of AMH in discriminating PCOS patients in all age categories.

Reproductive Biology and Endocrinology
Source: https://doi.org/10.1186/s12958-021-00755-8
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