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晚育年龄女性抑郁症病史与抗苗勒管激素之间的关联:哈佛情绪与周期研究

Association between a history of depression and anti-müllerian hormone among late-reproductive aged women: the Harvard study of moods and cycles.

作者信息

Golenbock Samuel W, Wise Lauren A, Lambert-Messerlian Geralyn M, Eklund Elizabeth E, Harlow Bernard L

机构信息

Department of Epidemiology, Boston University School of Public Health, 715 Albany St, Boston, MA 02118 USA.

Department of Pathology and Laboratory Medicine, Alpert Medical School at Brown University, 222 Richmond St, Providence, RI 02903 USA.

出版信息

Womens Midlife Health. 2020 Sep 1;6:9. doi: 10.1186/s40695-020-00056-x. eCollection 2020.

Abstract

BACKGROUND

There is conflicting evidence regarding the association between a history of depression and risk of early menopause. In a cohort of premenopausal women, we investigated the association between depression history and ovarian reserve, as measured by anti-müllerian hormone (AMH).

METHODS

The Harvard Study of Moods and Cycles (HSMC) was a prospective cohort study of women living in the Boston, MA metropolitan-area (1995-1999). Women aged 36-45 years at cohort entry (1995) were sampled from seven Boston metropolitan-area communities using census directories. We measured serum AMH in early-follicular phase venous blood specimens from 141 women with a Structured Clinical Interview for DSM-IV (SCID)-confirmed history of depression and 228 without such a history. We calculated prevalence ratios (PR) for the association between characteristics of depression history and low AMH (≤1.4 ng/mL), adjusting for several potential confounders.

RESULTS

The prevalence of low AMH was similar among depressed (57.5%) and non-depressed (57.9%) women (Adjusted [Adj] PR = 0.90, 95% CI: 0.75, 1.08). Among depressed women, results were not appreciably different among those who had ever used antidepressants and those with comorbid anxiety. Modest inverse associations between depression and low AMH were seen among women aged 36-40 years (Adj PR = 0.75, 95% CI: 0.52, 1.09) and nulliparous women (Adj PR = 0.77, 95% CI: 0.59, 1.00). No dose-response association with greater duration or length of depressive symptoms was observed.

CONCLUSIONS

Overall, the prevalence of low AMH was similar for depressed and non-depressed women 36-45 years of age. Surprisingly, among younger and nulliparous women, those with a history of depression had a slightly reduced prevalence of low AMH relative to those without such a history. These results do not indicate reduced ovarian reserve among women with a history of depression.

摘要

背景

关于抑郁症病史与早期绝经风险之间的关联,证据存在冲突。在一组绝经前女性中,我们研究了抑郁症病史与通过抗苗勒管激素(AMH)测量的卵巢储备之间的关联。

方法

哈佛情绪与周期研究(HSMC)是一项对居住在马萨诸塞州波士顿市区(1995 - 1999年)女性的前瞻性队列研究。队列入组时(1995年)年龄在36 - 45岁的女性使用人口普查目录从波士顿市区的七个社区中抽样选取。我们测量了141名有DSM-IV结构化临床访谈(SCID)确诊抑郁症病史的女性和228名无此类病史女性的卵泡早期静脉血标本中的血清AMH。我们计算了抑郁症病史特征与低AMH(≤1.4 ng/mL)之间关联的患病率比(PR),并对几个潜在混杂因素进行了调整。

结果

抑郁女性(57.5%)和非抑郁女性(57.9%)中低AMH的患病率相似(调整后[Adj]PR = 0.90,95%CI:0.75,1.08)。在抑郁女性中,曾经使用过抗抑郁药的女性和伴有共病焦虑的女性之间结果无明显差异。在36 - 40岁的女性(调整后PR = 0.75,95%CI:0.52,1.09)和未生育女性(调整后PR = 0.77,95%CI:0.59,1.00)中观察到抑郁症与低AMH之间存在适度的负相关。未观察到与抑郁症状持续时间或长度的剂量反应关联。

结论

总体而言,36 - 45岁抑郁和非抑郁女性中低AMH的患病率相似。令人惊讶的是,在年轻和未生育女性中,有抑郁症病史的女性相对于无此类病史的女性,低AMH的患病率略有降低。这些结果并不表明有抑郁症病史的女性卵巢储备减少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f58d/7461252/ed7b1be90053/40695_2020_56_Fig1_HTML.jpg

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