title: Prediction of age at menopause from assessment of ovarian reserve may be improved by using body mass index and smoking status.
abstract: OBJECTIVE
  Menopause is the consequence of exhaustion of the ovarian follicular pool. AMH, an indirect hormonal marker of ovarian reserve, has been recently proposed as a predictor for age at menopause. Since BMI and smoking status are relevant independent factors associated with age at menopause we evaluated whether a model including all three of these variables could improve AMH-based prediction of age at menopause.
  
  
  METHODS
  In the present cohort study, participants were 375 eumenorrheic women aged 19-44 years and a sample of 2,635 Italian menopausal women. AMH values were obtained from the eumenorrheic women.
  
  
  RESULTS
  Regression analysis of the AMH data showed that a quadratic function of age provided a good description of these data plotted on a logarithmic scale, with a distribution of residual deviates that was not normal but showed significant left-skewness. Under the hypothesis that menopause can be predicted by AMH dropping below a critical threshold, a model predicting menopausal age was constructed from the AMH regression model and applied to the data on menopause. With the AMH threshold dependent on the covariates BMI and smoking status, the effects of these covariates were shown to be highly significant.
  
  
  CONCLUSIONS
  In the present study we confirmed the good level of conformity between the distributions of observed and AMH-predicted ages at menopause, and showed that using BMI and smoking status as additional variables improves AMH-based prediction of age at menopause.
authors.affiliation: Mother-Infant Department, Institute of Obstetrics and Gynecology, University of Modena and Reggio Emilia, Modena, Italy. antlamarca@libero.it
authors.forename: Antonio
authors.initials: A
authors.lastname: La Marca
authors.forename: Giovanna
authors.initials: G
authors.lastname: Sighinolfi
authors.forename: Enrico
authors.initials: E
authors.lastname: Papaleo
authors.forename: Angelo
authors.initials: A
authors.lastname: Cagnacci
authors.forename: Annibale
authors.initials: A
authors.lastname: Volpe
authors.forename: Malcolm J
authors.initials: MJ
authors.lastname: Faddy
mesh_terms: D000328:Adult; D000367:Age Factors; D054304:Anti-Mullerian Hormone / Q000097:blood; D015992:Body Mass Index; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008593:Menopause; D010053:Ovary; D012907:Smoking; D055815:Young Adult
chemical_list: D054304:Anti-Mullerian Hormone