title: Age-Specific Normal Reference Range for Serum Anti-Müllerian Hormone in Healthy Chinese Han Women: A nationwide Population-Based Study.
abstract: The increasing use of anti-Müllerian hormone (AMH) in clinic has raised concerns regarding the reliable reference range for this test. However, the reference range for AMH in normal Chinese female population has not been established. Furthermore, relationship between AMH and other clinical markers such as body mass index (BMI) and antral follicle counts (AFCs) and other sex-related hormones have not been examined in normal population-based women.
  
  
  
  We aimed to determine the age-specific reference range for serum AMH in healthy Chinese women throughout reproductive age to menopause and to estimate relationship between AMH and other clinical markers in healthy women.
  
  
  
  In this multicenter and nationwide study, advertisements were used to recruit 2055 women, aged 20 to 55 years, from 6 different regions in China; 1590 (77.37%) women met the inclusion criteria for the reference range population. We measured the baseline serum AMH levels using new Beckman Coulter Gen II assay. Serum concentration of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), testosterone (T), prolactin (PRL), progesterone (PRG), and AFCs were also determined in the follicular phase.
  
  
  
  The AMH-Age nomogram and AMH levels of different age-groups and the relationship between AMH and other clinical markers.
  
  
  
  Serum AMH concentrations declined progressively with age. A quadratic model defined as log (AMH) = (-1.970 + 0.296 × Age - 0.006 × Age(2)) fitted best the decline of AMH with age. The median AMH levels were 6.23, 5.65, 4.55, 3.74, 2.78, and 1.09 ng/mL for the 20 ≤ age < 25, 25 ≤ age < 30, 30 ≤ age < 33, 33 ≤ age < 37, 37 ≤ age < 40, and 40 ≤ age < 55 groups, respectively. The 5th to 95th percentiles of the AMH levels, as the reference range, were 2.06 to 12.66, 1.77 to 13.83, 1.48 to 11.45, 0.87 to 9.76, 0.56 to 9.49, and 0.08 to 5.70 ng/mL for each age-group. The AMH levels were positively correlated with AFCs and T, LH, PRL and PRG levels and negatively correlated with BMI and FSH levels and were not significantly correlated with E2 levels. The relationship between AMH and other variables remain unchanged except for PRL, which was not significantly correlated with AMH levels after controlling for both age and BMI.
  
  
  
  This study determined the normal reference ranges for serum AMH levels in a large population-based sample of healthy Chinese women.
authors.affiliation: Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Xiaofang
authors.initials: X
authors.lastname: Du
authors.affiliation: Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Ding
authors.affiliation: Reproductive Medical Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Hanwang
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Reproductive Medical Center, Henan Provincial People's Hospital, Zhengzhou, China Reproductive Medical Center, the People's Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: Cuilian
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Reproductive Medical Center, Foshan Maternal and Child Health Care Hospital, Foshan, China.
authors.forename: Wenmin
authors.initials: W
authors.lastname: Ma
authors.affiliation: Reproductive Medical Center, Chengdu Jinjiang Maternal and Child Health Hospital, Chengdu, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhong
authors.affiliation: Reproductive Medical Center, Shenyang women's and children's hospital, Shenyang, China.
authors.forename: Wenyu
authors.initials: W
authors.lastname: Qu
authors.affiliation: Reproductive Medical Center, Maternal and Child Health Hospital of Hubei Province, Wuhan, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Zheng
authors.affiliation: Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Obstetrics and Gynecology, Renhe Hospital, China Three Gorges University, Yichang, China.
authors.forename: Zhiying
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Kecheng
authors.initials: K
authors.lastname: Huang
authors.affiliation: Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Song
authors.initials: S
authors.lastname: Deng
authors.affiliation: Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Lanfang
authors.initials: L
authors.lastname: Ma
authors.affiliation: Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Jingjing
authors.initials: J
authors.lastname: Jiang
authors.affiliation: Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Shuhong
authors.initials: S
authors.lastname: Yang
authors.affiliation: Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Jia
authors.initials: J
authors.lastname: Huang
authors.affiliation: Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Meng
authors.initials: M
authors.lastname: Wu
authors.affiliation: Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Li
authors.initials: L
authors.lastname: Fang
authors.affiliation: Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Yunping
authors.initials: Y
authors.lastname: Lu
authors.affiliation: Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China sxwang2012@163.com aiyueluoluck@163.com.
authors.forename: Aiyue
authors.initials: A
authors.lastname: Luo
authors.affiliation: Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China sxwang2012@163.com aiyueluoluck@163.com.
authors.forename: Shixuan
authors.initials: S
authors.lastname: Wang
mesh_terms: D000328:Adult; D000367:Age Factors; D054304:Anti-Mullerian Hormone / Q000097:blood*; D044466:Asian People; D003430:Cross-Sectional Studies; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008875:Middle Aged; D011374:Progesterone / Q000097:blood; D011388:Prolactin / Q000097:blood; D012016:Reference Values; D013739:Testosterone / Q000097:blood; D016387:Women's Health; D055815:Young Adult
chemical_list: D013739:Testosterone; D011374:Progesterone; D004958:Estradiol; D054304:Anti-Mullerian Hormone; D011388:Prolactin; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone
keywords: AMH; Chinese women; nationwide population-based study; reference range