title: Association of anti-mullerian hormone levels with obesity in late reproductive-age women.
abstract: OBJECTIVE
  To describe anti-mullerian hormone (AMH) levels in healthy late reproductive age women and test the hypothesis that AMH levels are lower in obese compared to non-obese women.
  
  
  METHODS
  Cross-sectional study of AMH levels. Longitudinal analysis of a subgroup with 10 AMH measures over 8 years to support the cross-sectional results.
  
  
  METHODS
  A population-based cohort of healthy late reproductive-age women.
  
  
  METHODS
  Selected from the cohort to provide comparisons of body mass index (BMI), menopausal status, age and race (n = 122).
  
  
  METHODS
  AMH levels were determined from blood samples collected in the parent study.
  
  
  METHODS
  Serum levels of AMH.
  
  
  RESULTS
  AMH levels were 65% lower in obese women compared to non-obese women (0.016 ng/mL and 0.046 ng/mL, respectively). The geometric mean ratio was 0.35; 95% CI 0.13, 0.92, P=.034. AMH levels were significantly lower in the menopausal transition compared to premenopausal women and were significantly lower in all age groups > or =40 years compared to the 35-39 year-old women. BMI remained significantly associated with AMH levels in multivariable models that included adjustments for menopausal status, age, race and cycle day. In the longitudinal analysis of a subgroup, obese women had significantly lower mean AMH levels over the 8-year interval compared to the non-obese women (0.459 ng/mL; CI 0.28, 0.75 and 0.566 ng/mL; CI 0.34, 0.94, respectively; P=.016), corroborating the cross-sectional study results.
  
  
  CONCLUSIONS
  Obese women have lower AMH levels compared to non-obese women in the late reproductive years. The findings offer further evidence of the complex relationships between obesity and reproductive hormone levels in women.
authors.affiliation: Department of Obstetrics/Gynecology, University of Pennsylvania, School of Medicine, Philadelphia, Pennsylvania 19104, USA. freemane@mail.med.upenn.edu
authors.forename: Ellen W
authors.initials: EW
authors.lastname: Freeman
authors.forename: Clarisa R
authors.initials: CR
authors.lastname: Gracia
authors.forename: Mary D
authors.initials: MD
authors.lastname: Sammel
authors.forename: Hui
authors.initials: H
authors.lastname: Lin
authors.forename: Lony Chong-Leong
authors.initials: LC
authors.lastname: Lim
authors.forename: Jerome F
authors.initials: JF
authors.lastname: Strauss
mesh_terms: D000367:Age Factors; D054304:Anti-Mullerian Hormone; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006023:Glycoproteins / Q000097:blood*; D006801:Humans; D008593:Menopause / Q000378:metabolism*; D008875:Middle Aged; D009765:Obesity / Q000097:blood*; D012098:Reproduction; D013223:Statistics as Topic; D013735:Testicular Hormones / Q000097:blood*
chemical_list: D006023:Glycoproteins; D013735:Testicular Hormones; D054304:Anti-Mullerian Hormone