Associations Between Anti-Mullerian Hormone and Cardiometabolic Health in Reproductive Age Women Are Explained by Body Mass Index

Julie S. Rios, Eleni A. Greenwood, Mary Ellen G. Pavone, Marcelle I. Cedars, Richard S. Legro, Michael P. Diamond, Nanette Santoro, Fangbai Sun, Randal D. Robinson, Gregory Christman, Heping Zhang, Heather G. Huddleston

Research output: Contribution to journalArticle

Abstract

CONTEXT: The relationship between reproductive and cardiometabolic aging is unclear. It is unknown if the relationship differs across different clinical populations. OBJECTIVE: To determine whether markers of ovarian reserve are associated with cardiometabolic risk in reproductive aged women with unexplained infertility (UI), polycystic ovary syndrome (PCOS), and regularly cycling women (OVA). DESIGN AND SETTING: Cross-sectional data from 8 US-based academic centers. PARTICIPANTS: Women aged 25-40 from 3 clinical populations: 870 with UI, 640 with PCOS, and 921 community-based OVA. MAIN OUTCOME MEASURES: Multivariable linear regression models were used to relate anti-mullerian hormone (AMH) and antral follicle count with cardiometabolic parameters including body mass index (BMI), waist circumference (WC), fasting glucose and insulin, homeostasis model assessment-insulin resistance (HOMA-IR), lipids, and C-reactive protein. RESULTS: In age and study site-adjusted models, AMH inversely related to BMI in the UI and OVA groups (P = 0.02 and P < 0.001). Among women with PCOS, AMH inversely related to BMI (P < 0.001), and also to WC (P < 0.001), fasting insulin (P < 0.01), HOMA-IR (P < 0.01), triglycerides (P = 0.04), and C-reactive protein (P < 0.001) and directly related to higher total (P = 0.02), low-density lipoprotein (P < 0.01), and high-density lipoprotein cholesterol (P < 0.01). In OVA, AMH also varied inversely with WC (P < 0.001), fasting insulin (P = 0.02), and HOMA-IR (P = 0.02). Adjustment for BMI eliminated associations in the OVA group but in PCOS, the relationship of AMH to total (P = 0.03) and low-density lipoprotein cholesterol (P = 0.003) remained. CONCLUSION: Associations observed between AMH and cardiometabolic indices are largely explained by BMI in women with and without PCOS. (J Clin Endocrinol Metab XX: 0-0, 2019).

Original languageEnglish (US)
JournalThe Journal of clinical endocrinology and metabolism
Volume105
Issue number1
DOIs
StatePublished - Jan 1 2020

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Anti-Mullerian Hormone
Reproductive Health
Polycystic Ovary Syndrome
Fasting
Body Mass Index
Health
Insulin
Waist Circumference
Infertility
Insulin Resistance
Homeostasis
C-Reactive Protein
Linear Models
LDL Lipoproteins
LDL Cholesterol
HDL Cholesterol
Population
Triglycerides
Lipids
Linear regression

Keywords

  • anti-mullerian hormone (AMH)
  • cardiometabolic health
  • cardiovascular risk
  • ovarian aging
  • ovarian reserve markers
  • reproductive aging

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Associations Between Anti-Mullerian Hormone and Cardiometabolic Health in Reproductive Age Women Are Explained by Body Mass Index. / Rios, Julie S.; Greenwood, Eleni A.; Pavone, Mary Ellen G.; Cedars, Marcelle I.; Legro, Richard S.; Diamond, Michael P.; Santoro, Nanette; Sun, Fangbai; Robinson, Randal D.; Christman, Gregory; Zhang, Heping; Huddleston, Heather G.

In: The Journal of clinical endocrinology and metabolism, Vol. 105, No. 1, 01.01.2020.

Research output: Contribution to journalArticle

Rios, JS, Greenwood, EA, Pavone, MEG, Cedars, MI, Legro, RS, Diamond, MP, Santoro, N, Sun, F, Robinson, RD, Christman, G, Zhang, H & Huddleston, HG 2020, 'Associations Between Anti-Mullerian Hormone and Cardiometabolic Health in Reproductive Age Women Are Explained by Body Mass Index', The Journal of clinical endocrinology and metabolism, vol. 105, no. 1. https://doi.org/10.1210/clinem/dgz012
Rios, Julie S. ; Greenwood, Eleni A. ; Pavone, Mary Ellen G. ; Cedars, Marcelle I. ; Legro, Richard S. ; Diamond, Michael P. ; Santoro, Nanette ; Sun, Fangbai ; Robinson, Randal D. ; Christman, Gregory ; Zhang, Heping ; Huddleston, Heather G. / Associations Between Anti-Mullerian Hormone and Cardiometabolic Health in Reproductive Age Women Are Explained by Body Mass Index. In: The Journal of clinical endocrinology and metabolism. 2020 ; Vol. 105, No. 1.
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AU - Rios, Julie S.

AU - Greenwood, Eleni A.

AU - Pavone, Mary Ellen G.

AU - Cedars, Marcelle I.

AU - Legro, Richard S.

AU - Diamond, Michael P.

AU - Santoro, Nanette

AU - Sun, Fangbai

AU - Robinson, Randal D.

AU - Christman, Gregory

AU - Zhang, Heping

AU - Huddleston, Heather G.

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N2 - CONTEXT: The relationship between reproductive and cardiometabolic aging is unclear. It is unknown if the relationship differs across different clinical populations. OBJECTIVE: To determine whether markers of ovarian reserve are associated with cardiometabolic risk in reproductive aged women with unexplained infertility (UI), polycystic ovary syndrome (PCOS), and regularly cycling women (OVA). DESIGN AND SETTING: Cross-sectional data from 8 US-based academic centers. PARTICIPANTS: Women aged 25-40 from 3 clinical populations: 870 with UI, 640 with PCOS, and 921 community-based OVA. MAIN OUTCOME MEASURES: Multivariable linear regression models were used to relate anti-mullerian hormone (AMH) and antral follicle count with cardiometabolic parameters including body mass index (BMI), waist circumference (WC), fasting glucose and insulin, homeostasis model assessment-insulin resistance (HOMA-IR), lipids, and C-reactive protein. RESULTS: In age and study site-adjusted models, AMH inversely related to BMI in the UI and OVA groups (P = 0.02 and P < 0.001). Among women with PCOS, AMH inversely related to BMI (P < 0.001), and also to WC (P < 0.001), fasting insulin (P < 0.01), HOMA-IR (P < 0.01), triglycerides (P = 0.04), and C-reactive protein (P < 0.001) and directly related to higher total (P = 0.02), low-density lipoprotein (P < 0.01), and high-density lipoprotein cholesterol (P < 0.01). In OVA, AMH also varied inversely with WC (P < 0.001), fasting insulin (P = 0.02), and HOMA-IR (P = 0.02). Adjustment for BMI eliminated associations in the OVA group but in PCOS, the relationship of AMH to total (P = 0.03) and low-density lipoprotein cholesterol (P = 0.003) remained. CONCLUSION: Associations observed between AMH and cardiometabolic indices are largely explained by BMI in women with and without PCOS. (J Clin Endocrinol Metab XX: 0-0, 2019).

AB - CONTEXT: The relationship between reproductive and cardiometabolic aging is unclear. It is unknown if the relationship differs across different clinical populations. OBJECTIVE: To determine whether markers of ovarian reserve are associated with cardiometabolic risk in reproductive aged women with unexplained infertility (UI), polycystic ovary syndrome (PCOS), and regularly cycling women (OVA). DESIGN AND SETTING: Cross-sectional data from 8 US-based academic centers. PARTICIPANTS: Women aged 25-40 from 3 clinical populations: 870 with UI, 640 with PCOS, and 921 community-based OVA. MAIN OUTCOME MEASURES: Multivariable linear regression models were used to relate anti-mullerian hormone (AMH) and antral follicle count with cardiometabolic parameters including body mass index (BMI), waist circumference (WC), fasting glucose and insulin, homeostasis model assessment-insulin resistance (HOMA-IR), lipids, and C-reactive protein. RESULTS: In age and study site-adjusted models, AMH inversely related to BMI in the UI and OVA groups (P = 0.02 and P < 0.001). Among women with PCOS, AMH inversely related to BMI (P < 0.001), and also to WC (P < 0.001), fasting insulin (P < 0.01), HOMA-IR (P < 0.01), triglycerides (P = 0.04), and C-reactive protein (P < 0.001) and directly related to higher total (P = 0.02), low-density lipoprotein (P < 0.01), and high-density lipoprotein cholesterol (P < 0.01). In OVA, AMH also varied inversely with WC (P < 0.001), fasting insulin (P = 0.02), and HOMA-IR (P = 0.02). Adjustment for BMI eliminated associations in the OVA group but in PCOS, the relationship of AMH to total (P = 0.03) and low-density lipoprotein cholesterol (P = 0.003) remained. CONCLUSION: Associations observed between AMH and cardiometabolic indices are largely explained by BMI in women with and without PCOS. (J Clin Endocrinol Metab XX: 0-0, 2019).

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KW - ovarian aging

KW - ovarian reserve markers

KW - reproductive aging

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