title: Race/ethnic disparities in reproductive age: an examination of ovarian reserve estimates across four race/ethnic groups of healthy, regularly cycling women.
abstract: OBJECTIVE
  To determine whether reproductive age, as indexed by a validated marker of ovarian reserve (antimüllerian hormone [AMH]), varies among women of different race/ethnic backgrounds.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Community-based sample.
  
  
  METHODS
  Multiethnic sample of 947 (277 white, 237 African American, 220 Latina, and 213 Chinese) healthy and regularly cycling premenopausal women, ages 25-45.
  
  
  METHODS
  None.
  
  
  METHODS
  AMH level.
  
  
  RESULTS
  A multivariate model was fit examining race/ethnicity, covariates, nonlinear terms for age (age(2), age(3)), and body mass index (BMI(2), BMI(3)), and two-way interactions between race/ethnicity and each of the other predictor variables in relation to AMH. After backward elimination, significant effects included race/ethnicity (F = 8.45), age (F = 349.94), race/ethnicity-by-linear age interaction (F = 4.67), age(2) (F = 31.61), and BMI (F = 10.69). Inspection of the significant race/ethnicity-by-linear age interaction showed AMH levels were consistently lower among Latina women compared with white women across all ages, whereas AMH levels were lower among African American and Chinese women compared with the white women at younger and middle ages, respectively. The AMH levels were higher among African American compared with Latina and Chinese women at older ages.
  
  
  CONCLUSIONS
  Although the results must be considered preliminary, the findings are twofold: African American women may have lower AMH levels at younger ages but experience less of a reduction in AMH with advancing age, and Latina and Chinese women compared with white women may have lower AMH levels, marking a lower ovarian reserve and a possibly increased risk for earlier menopause.
authors.affiliation: Department of Psychiatry, University of California San Francisco, San Francisco, California. Electronic address: maria.bleil@ucsf.edu.
authors.forename: Maria E
authors.initials: ME
authors.lastname: Bleil
authors.affiliation: Department of Medicine, University of California San Francisco, San Francisco, California.
authors.forename: Steven E
authors.initials: SE
authors.lastname: Gregorich
authors.affiliation: Department of Psychiatry, University of California San Francisco, San Francisco, California.
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Adler
authors.affiliation: Division of Research, Kaiser Permanente of Northern California, Oakland, California.
authors.forename: Barbara
authors.initials: B
authors.lastname: Sternfeld
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California.
authors.forename: Mitchell P
authors.initials: MP
authors.lastname: Rosen
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California.
authors.forename: Marcelle I
authors.initials: MI
authors.lastname: Cedars
mesh_terms: D000328:Adult; D001741:Black or African American / Q000208:ethnology; D000367:Age Factors; D054304:Anti-Mullerian Hormone / Q000097:blood*; D044466:Asian People / Q000208:ethnology; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000208:ethnology*; D005260:Female; D006630:Hispanic or Latino / Q000208:ethnology; D006801:Humans; D008597:Menstrual Cycle / Q000208:ethnology* / Q000502:physiology*; D008875:Middle Aged; D010053:Ovary / Q000378:metabolism*; D044469:Racial Groups / Q000208:ethnology; D012098:Reproduction / Q000502:physiology*; D044465:White People / Q000208:ethnology
chemical_list: D015415:Biomarkers; D054304:Anti-Mullerian Hormone
keywords: Antimüllerian hormone (AMH); menopause; ovarian reserve; race/ethnicity; reproductive aging