Diagnostic value of ultrasound combined with AMH,insulin and three sex hormones in polycystic ovary syndrome

LI Qiping; WU Chutong; LIANG Zhicun; LI Lihong; JIANG Chaoxin

doi:10.3969/j.issn.1002-3429.2026.06.013

Abstract：Objective To investigate the diagnostic value of ultrasound combined with anti-mullerian hormone(AMH),insulin and three sex hormones in polycystic ovary syndrome(PCOS).Methods A total of 90 patients with PCOS treated from January 2024 to July 2025 were selected as the observation group,and 45 healthy physical examinees during the same period were selected as the control group for case-control study.The baseline data,ultrasound indexes[ovarian volume(OV),antral follicle count(AFC),total ovarian area(TA),ovarian stromal area(SA),peak systolic velocity(PSV),end diastolic velocity(EDV),resistance index(RI),pulsatility index(PI)],AMH,insulin[fasting insulin(FINS),Homeostatic Model Assessment for Insulin Resistance(HOMA-IR)]and three sex hormones[testosterone,luteinizing hormone(LH),follicle stimulating hormone(FSH)]were compared between the two groups.Multivariate Logistic regression analysis was used to analyze the factors affecting the occurrence of PCOS.The receiver operating characteristic(ROC)curve was used to analyze the value of ultrasound indicators,AMH,insulin and sex hormones alone and in combination for the diagnosis of PCOS.The decision curve was used to evaluate the clinical utility of the combined diagnostic model,and the K-fold cross-validation was used to verify its generalization ability.Results There were significant differences in neutrophil(NEU),neutrophil/lymphocyte ratio(NLR),AMH,fasting plasma glucose(FPG),FINS,HOMA-IR,testosterone,LH,FSH and LH/FSH between the two groups(P<0.01).The values of OV,AFC,SA,PSV and EDV in the observation group were higher than those in the control group,and the values of RI and PI were lower than those in the control group(P<0.05,P<0.01).Multivariate Logistic regression analysis showed that after adjusting for confounding factors,AMH,HOMA-IR,testosterone,LH/FSH,OV and RI were still the factors affecting the occurrence of PCOS(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of AMH,HOMA-IR,testosterone,LH/FSH,OV and RI in the diagnosis of PCOS was in the range of 0.717-0.781,and the AUC of combined diagnosis was 0.887(95%CI:0.821,0.935),which was greater than the AUC value of each indicator alone(P<0.05).The decision curve showed that the joint diagnosis model showed good clinical net income within the threshold probability range of 0.2-0.8 threshold;the K-fold cross-validation showed that the mean AUC value of the five validations was 0.8864,which was basically consistent with the AUC value(0.887)obtained by modeling,and the data were highly concentrated and the generalization ability was good.Conclusion Ultrasound combined with AMH,insulin and three sex hormones has certain diagnostic value for PCOS,which can be used as an auxiliary scheme to optimize the clinical diagnosis of PCOS.