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Serum AMH has specific diagnostic value for PCOS, yet their differential expression and clinical significance in obese versus non-obese PCOS phenotypes remain unclear. To fill this gap, we performed the first systematic review and meta-analysis comparing serum AMH and INHB levels between obese and non-obese women with PCOS, and explored heterogeneity sources.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Thirty-eight observational studies (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200915,003) were systematically retrieved and quality-assessed via the Newcastle-Ottawa Scale (NOS), with all scoring\u2009\u2265\u20097. Meta-analyses calculated pooled standardized mean differences (SMDs) for AMH and INHB levels, with subgroup analyses stratified by geographic region, BMI category, and age. Meta-regression analyzed the effects of these factors on AMH levels; sensitivity analyses and publication bias assessments verified result robustness.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Obese PCOS women had significantly lower serum AMH (SMD: \u22120.16; 95% CI: \u22120.29 to \u22120.02;\n                      <jats:italic>P<\/jats:italic>\n                      =0.02;\n                      <jats:italic>I\u00b2<\/jats:italic>\n                      =86%) and INHB (SMD: \u22120.98; 95% CI: \u22121.60 to \u22120.36;\n                      <jats:italic>P<\/jats:italic>\n                      =0.002;\n                      <jats:italic>I\u00b2<\/jats:italic>\n                      =90%) than non-obese counterparts. Meta-regression found no significant associations between AMH levels and geography (\n                      <jats:italic>P<\/jats:italic>\n                      =0.6516), BMI (\n                      <jats:italic>P<\/jats:italic>\n                      =0.2598), or age (\n                      <jats:italic>P<\/jats:italic>\n                      =0.5353). Subgroup analyses showed the most pronounced AMH differences in BMI \u226428 kg\/m\u00b2 (\n                      <jats:italic>P<\/jats:italic>\n                      =0.01) and \u226518-year-old (\n                      <jats:italic>P<\/jats:italic>\n                      =0.02) subgroups, with reduced heterogeneity here. AMH results were stable in sensitivity analysis, while INHB findings relied on a single study; funnel plot asymmetry suggested potential publication bias for AMH studies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Obesity correlates with markedly reduced AMH and INHB in PCOS, indicating metabolic impacts on ovarian reserve biomarkers. These findings highlight the need for weight-stratified interpretation of such markers and further investigation into obesity-related mechanisms in PCOS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12958-026-01576-3","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:55:01Z","timestamp":1781484901000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Does obesity affect serum anti-m\u00fcllerian hormone or inhibin B levels in polycystic ovary syndrome? 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