From the Lifecourse Epidemiology of Adiposity and Diabetes Center, Colorado School of Public Health, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO.
Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, and Harvard Pilgrim Health Care Institute, Landmark Center, Boston, MA.
Menopause. 2023 Mar 1;30(3):247-253. doi: 10.1097/GME.0000000000002143. Epub 2023 Jan 4.
This study aimed to examine the association of antimüllerian hormone (AMH) with concurrent and prospective measures of adiposity during approximately 9 years of follow-up.
Participants were 697 parous women from the Project Viva prebirth cohort without polycystic ovarian syndrome. We measured AMH at approximately 3 years postpartum (baseline). Outcomes were weight, body mass index (BMI), and waist circumference assessed at baseline, 4, and 9 years later; % body fat was assessed by bioimpedance at the 4- and 9-year visit. We used linear mixed-effect models including all outcome time points and accounting for age across follow-up and hormonal contraception prescription. In an additional model, we further adjusted for height.
Median AMH was 1.97 ng/mL (interquartile range, 0.83-4.36 ng/mL), 29.1% had AMH <1.0 ng/mL, and mean age at AMH measurement was 36.7 years (SD, 4.9 y; range, 20-48 y). AMH was inversely associated with average weight, BMI, and waist circumference over follow-up. In age-adjusted models, women with AMH <1.0 versus ≥1.0 ng/mL were 4.92 kg (95% CI, 2.01-7.82 kg) heavier, had a 2.51 cm (95% CI, 0.12-4.89 cm) greater waist circumference, and a 1.46 kg/m 2 (95% CI, 0.44-2.48 kg/m 2 ) greater BMI across the 9 years of follow-up. Findings were similar after covariate adjustment and when AMH was modeled continuously. AMH was also inversely associated with higher fat mass %; however, the CI crossed the null.
Low AMH at baseline was associated with greater adiposity concurrently and across approximately 9 years of follow-up. Whether low AMH is a useful marker of metabolic risk across midlife requires further research.
本研究旨在探讨抗苗勒管激素（AMH）与大约 9 年随访期间肥胖的并发和前瞻性指标之间的关系。
参与者为来自 Project Viva 产前队列的 697 名经产妇女，没有多囊卵巢综合征。我们在产后约 3 年（基线）时测量 AMH。结局为在基线、4 年和 9 年后测量的体重、体重指数（BMI）和腰围；在 4 年和 9 年的随访中通过生物电阻抗评估体脂肪百分比。我们使用线性混合效应模型，包括所有结局时间点，并在随访过程中考虑年龄和激素避孕处方。在另一个模型中，我们进一步调整了身高。
中位 AMH 为 1.97ng/ml（四分位距，0.83-4.36ng/ml），29.1%的 AMH<1.0ng/ml，AMH 测量时的平均年龄为 36.7 岁（标准差，4.9y；范围，20-48y）。AMH 与随访期间的平均体重、BMI 和腰围呈负相关。在年龄调整模型中，AMH<1.0ng/ml 与 AMH≥1.0ng/ml 的女性相比，体重增加了 4.92kg（95%置信区间，2.01-7.82kg），腰围增加了 2.51cm（95%置信区间，0.12-4.89cm），BMI 增加了 1.46kg/m 2（95%置信区间，0.44-2.48kg/m 2），随访 9 年。在协变量调整后和 AMH 连续建模时，结果相似。AMH 也与较高的脂肪百分比呈负相关；然而，CI 与零相交。
基线时 AMH 较低与大约 9 年随访期间的肥胖并发和进展有关。在中年期间，低 AMH 是否是代谢风险的有用标志物需要进一步研究。
