Anti‐Müllerian hormone, a Sertoli cell‐derived marker, is decreased in plasma of male patients in all stages of chronic kidney disease

Abstract

SUMMARYMale patients with terminal renal failure are often infertile and exhibit an abnormal sex hormone pattern in plasma. We studied patients in all chronic kidney disease (CKD) stages to determine plasma levels of anti-M€ ullerian hormone (AMH), a Sertoli cellderived marker, and other sex hormones. Seventy-eight male patients with CKD stages 1-5 and a median age of 40 years (22-50 years), as well as 20 healthy controls with a median age of 37 years (26-44 years), were enrolled. The CKD patients were evenly distributed; 18 with CKD stages 1-2, 19 with CKD stage 3, 19 with CKD stage 4, and 22 with CKD stage 5. Cystatin C, follicle-stimulating hormone, luteinizing hormone, prolactin, sex hormone-binding globulin, testosterone, and AMH levels in plasma were analysed. AMH was analysed using the Ansh Labs UltraSensitive AMH assay. Several changes occurred in plasma levels of sex hormones in male patients with CKD. Plasma AMH levels were lower in CKD stages 1-4 by 30% (p = 0.041) and by 70% (p < 0.001) in CKD stage 5 compared with controls. Plasma luteinizing hormone and prolactin levels were higher and testosterone levels were lower compared with controls. The pathophysiological role of this reduction in AMH is unclear, but can be linked to altered Sertoli cell function.

MicroRNA-155 and Anti-Müllerian Hormone: New Potential Markers of Subfertility in Men with Chronic Kidney Disease

“…Previous explanations include disturbances in the hypothalamic-pituitary-gonadal axis resulting in altered levels of luteinizing hormone, follicle-stimulating hormone, and testosterone. Our findings in this and previous studies [6, 7] show that the absolute change in plasma AMH and miR-155 levels were greater than those of testosterone. Successful renal transplantation has been shown to normalize testosterone deficiency in uremic men [29].…”

“…We found no association between miR-155 and CRP in this CKD population, indicating that the elevated miR-155 levels were a response to a mechanism other than inflammation associated with CRP as a cause of impaired semen quality. We have recently reported major decreases in plasma levels of AMH, a marker of Sertoli cell function, in men with CKD [6, 7]. To evaluate this in relation to fertility, we included assay of AMH levels in this study, and found an association between low AMH levels and a low percentage of motile sperm cells in the entire study population.…”

“…Deterioration of kidney function may also imply disturbances of the hypothalamic-pituitary-gonadal axis with increased levels of luteinizing hormone and follicle-stimulating hormone and decreased testosterone levels [3, 4, 5]. We have previously shown that anti-müllerian hormone (AMH), a marker of Sertoli cell function, is decreased in all men with CKD [6], being most pronounced in CKD 5 [7]. Low AMH levels have also been seen in subfertile men without renal disease [8] and in men with nonobstructive azoospermia [9].…”

Circulating 25-hydroxy vitamin D correlates with serum level of anti-Müllerian hormone in male patients with chronic kidney disease

“…This is consistent with Eckersten, Giwercman, Bruun, et al. () who showed for the first time that plasma AMH level was decreased in dialysis patients and in men with mild and moderate renal dysfunction. However, the authors did not find a cause for the decreased AMH level, but they speculated on the effects of inflammation, uraemic toxicity or other causes.…”

“…In CKD, Eckersten, Giwercman, Bruun, and Christensson () reported that the mean plasma AMH level in stages 1–4 was lower than that in controls and represented a decrease by 30%. Furthermore, AMH level was found to be greatly decreased in male patients with ESRD which may reflect SC impairment in those patients (Eckersten, Giwercman, & Christensson, ).…”