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ABSTRAK Latar Belakang: Sindroma ovarium polikistik (SOPK) merupakan kelainan
kompleks endokrin terbanyak pada usia reproduksi. Ketidakseimbangan hormon
merupakan salah satu temuan SOPK yang terkait dengan patofisiologinya.
Adanya perbedaan kejadian resistensi insulin mungkin terkait dengan perbedaan
karakteristik hormon pada pasien SOPK pada berbagai fenotipe, salah satunya
Hormon Anti-Mullerian (HAM).
Metode: Desain penelitian potong lintang (cross sectional), pengambilan subjek
dimulai dari identifikasi kelompok dengan SOPK menggunakan titik potong
HAM >4,45 ng/dl, lalu akan dikelompokkan menjadi empat kelompok sesuai
dengan fenotipnya berdasarkan kriteria Rotterdam 2003, di klinik Yasmin dan
Makmal Endokrinologi di bagian Obstetri dan Ginekologi RSUPN Dr.Cipto
Mangunkusumo selama tahun 2011 ?2014. Resistensi insulin dinilai
menggunakan homeostatic model assessment for insulin resistance (HOMA IR).
Hasil: Didapatkan 125 subjek SOPK dengan kadar HAM cenderung lebih tinggi
pada fenotipe 1 dan lebih rendah pada fenotipe 4 (p<0,05). Selain itu, ditemukan
perbedaan kadar LH dan rasio LH/FSH pada keempat fenotipe (p<0,05). Nilai
HOMA IR juga lebih tinggi pada fenotipe 1 (p<0,05). Berdasarkan analisis regresi
linear, didapatkan indeks massa tubuh dan HAM berkorelasi positif dengan nilai
HOMA IR (r=0,19 p=0,015 dan r=0,53 p<0,001, berturut-turut).
Kesimpulan: Terdapat korelasi positif kadar HAM terhadap nilai HOMA IR.
Pada keempat fenotipe SOPK didapatkan kadar HAM dan HOMA IR lebih tinggi
pada fenotipe 1 dan semakin rendah pada fenotipe 4.
ABSTRACT Background: Polycystic ovary syndrome (PCOS) is an endocrine disorder that isthe most complex in the reproductive age. Hormonal imbalance remains a part ofits pathophysiology. Insulin resistance might be linked with difference inhormonal parameter across four phenotypes of PCOS, especillay in AMH level.Method: The study design was cross-sectional (cross-sectional). Subject retrievalstarts from the identification of the group with PCOS (with cutt-off AMH serum>4.45 ng/dl), and will be grouped into four groups according to their phenotypebased on the criteria of Rotterdam in 2003, in the clinic Yasmin andEndocrinology Laboratory at the Obstetrics and Gynecology RSUPN Dr.CiptoMangunkusomo during 2011 -2014. Insulin resistance was counted usinghomeostatic model assessment for insulin resistance (HOMA IR).Result: A total of 125 PCOS patients were recruited with AMH serumsignificantly higher among phenotype 1 and lower among phenotype 4 (p<0.05).Besides, Lh serum and LH/FSH ratio were also different across four phenotypes(p<0.05). The value of HOMA IR tend to be higher among phenotype 1 (p<0.05).Using multivariable linear regression analysis, body mass index and AMH serumwere positively correlated with HOMA IR (r=0.19 p=0.015 and r=0.53 p<0.001,respectively).Conclusion: There was a positive correlation between AMH serum and HOMAIR value. The four PCOS phenotypes had significantly different value of HAMserum and HOMA IR with phenotype 1 possed higher value among the others.;Background: Polycystic ovary syndrome (PCOS) is an endocrine disorder that isthe most complex in the reproductive age. Hormonal imbalance remains a part ofits pathophysiology. Insulin resistance might be linked with difference inhormonal parameter across four phenotypes of PCOS, especillay in AMH level.Method: The study design was cross-sectional (cross-sectional). Subject retrievalstarts from the identification of the group with PCOS (with cutt-off AMH serum>4.45 ng/dl), and will be grouped into four groups according to their phenotypebased on the criteria of Rotterdam in 2003, in the clinic Yasmin andEndocrinology Laboratory at the Obstetrics and Gynecology RSUPN Dr.CiptoMangunkusomo during 2011 -2014. Insulin resistance was counted usinghomeostatic model assessment for insulin resistance (HOMA IR).Result: A total of 125 PCOS patients were recruited with AMH serumsignificantly higher among phenotype 1 and lower among phenotype 4 (p<0.05).Besides, Lh serum and LH/FSH ratio were also different across four phenotypes(p<0.05). The value of HOMA IR tend to be higher among phenotype 1 (p<0.05).Using multivariable linear regression analysis, body mass index and AMH serumwere positively correlated with HOMA IR (r=0.19 p=0.015 and r=0.53 p<0.001,respectively).Conclusion: There was a positive correlation between AMH serum and HOMAIR value. The four PCOS phenotypes had significantly different value of HAMserum and HOMA IR with phenotype 1 possed higher value among the others.;Background: Polycystic ovary syndrome (PCOS) is an endocrine disorder that isthe most complex in the reproductive age. Hormonal imbalance remains a part ofits pathophysiology. Insulin resistance might be linked with difference inhormonal parameter across four phenotypes of PCOS, especillay in AMH level.Method: The study design was cross-sectional (cross-sectional). Subject retrievalstarts from the identification of the group with PCOS (with cutt-off AMH serum>4.45 ng/dl), and will be grouped into four groups according to their phenotypebased on the criteria of Rotterdam in 2003, in the clinic Yasmin andEndocrinology Laboratory at the Obstetrics and Gynecology RSUPN Dr.CiptoMangunkusomo during 2011 -2014. Insulin resistance was counted usinghomeostatic model assessment for insulin resistance (HOMA IR).Result: A total of 125 PCOS patients were recruited with AMH serumsignificantly higher among phenotype 1 and lower among phenotype 4 (p<0.05).Besides, Lh serum and LH/FSH ratio were also different across four phenotypes(p<0.05). The value of HOMA IR tend to be higher among phenotype 1 (p<0.05).Using multivariable linear regression analysis, body mass index and AMH serumwere positively correlated with HOMA IR (r=0.19 p=0.015 and r=0.53 p<0.001,respectively).Conclusion: There was a positive correlation between AMH serum and HOMAIR value. The four PCOS phenotypes had significantly different value of HAMserum and HOMA IR with phenotype 1 possed higher value among the others."
