Anti-mullerian hormone (AMH) is associated with natural menopause in a population-based sample: The CARDIA Women's Study

Abstract

Objective AMH is associated with menopausal timing in several studies. In contrast to prior studies that were restricted to women with regular cycles, our objective was to examine this association in women with either regular or irregular menstrual cycles. Methods CARDIA is a longitudinal, population-based study that recruited adults ages 18–30 when it began in 1985–86. AMH was measured in serum stored in 2002–03. Natural menopause was assessed by survey in 2005–06 and 2010–11. Results Among 716 premenopausal women, median [25th, 75th] AMH was 0.77 [0.22–2.02] ng/dL at a median age of 42 [39–45] years. Twenty-nine percent of the women (n=207) reported natural menopause during 9 years of follow up. In fully adjusted discrete-time hazard models, a 0.5 ng/dL AMH decrement was associated with higher risk of menopause (p<0.001). Hazard ratios varied with time since AMH measurement. The HR (95% CI) for menopause was 8.1 (2.5–26.1) within 0–3 years and 2.3 (1.7–3.3) and 1.6 (1.3–2.1) for 3–6 and 6–9 years, respectively. When restricted to women with regular menses, results were similar (e.g., HR=6.1; 95% CI: 1.9–20.0 for 0–3 years). Conclusion AMH is independently associated with natural menopause. AMH appears most useful in identifying women at risk of menopause in the near future (within 3 years of AMH measurement).

Anti-Müllerian hormone, follicle stimulating hormone, antral follicle count, and risk of menopause within 5 years

“…Third, the cohort included women who were drawn from a population-based sample, whereas previous cohorts focused upon women with regular menstrual cycles, women undergoing infertility evaluations, and women not using OCPs, interfering with the interpretation of results from women who did not fit these criteria. Similarly, approximately half of the population in our report was African-American, an important characteristic to consider given that the CARDIA study [8] and at least one other report have noted racial/ethnic differences in AMH concentrations between blacks and whites [24]. Finally, our study addresses several of the limitations of ovarian reserve measurements mentioned in the previous paragraph, including imprecise and relatively less sensitive AMH assays; AFC estimates generated from single-center reports; and the inaccuracy of risk models which assume uniform risks over time.…”

“…Previous reports, including those by our group as well as others, have noted that measures of ovarian reserve can predict age at menopause [8, 10, 15–20]. However, implementation in the clinical setting has been limited by several factors.…”

“…Low serum anti-Müllerian hormone (AMH) [8], high serum follicle stimulating hormone (FSH) levels [9], and low antral follicle count (AFC) [10] are associated with the onset of menopause. However, which of these measures or combination of measures best predicts menopause is not clear.…”

Testosterone Levels in Pre-Menopausal Women are Associated With Nonalcoholic Fatty Liver Disease in Midlife

“…We utilized data from the CARDIA cohort (11,12), and the CARDIA Women’s Study (CWS) (13,14), an ancillary study to CARDIA. The CARDIA cohort is a multicenter community-based longitudinal study of cardiovascular disease in young African American and Caucasian adults aged 18–30 years.…”

“…Blood draws targeted the follicular phase of the menstrual cycle (13). Measurements included total testosterone, free testosterone, and sex hormone binding globulin (SHBG) performed at the Obstetrics and Gynecology Research and Diagnostic Laboratory at the University of Alabama, Birmingham.…”