title: Serum anti-mullerian hormone and all-cause mortality in men.
abstract: Several studies have examined an association of anti-mullerian hormone to various risk factors for mortality, however, to the best of our knowledge, no study has reported a direct relationship between anti-mullerian hormone and all-cause mortality. Therefore, we examined the relationship between baseline anti-mullerian hormone levels and subsequent all-cause mortality in men during median follow-up of 9.4 (range = 0-13) years. We used the continuous National Health and Nutrition Examination Surveys from 1999-2004 combined with National Death Index for vital status information through December 2011. Cox proportional hazard models were fit to estimate hazard ratios for all-cause mortality. Models were adjusted for age, ethnic background, body mass index, hypertension, diabetes, smoking status, c-reactive protein, total cholesterol, estimated glomerular filtration rate, serum estradiol, testosterone, sex hormone binding globulin, and androstenedione. Of the 989 men, 30 % were older than 65 years, 51 % were Caucasians, 33 % had hypertension, 27 % were active smokers, and 11 % had diabetes. Mean serum anti-mullerian hormone level of the population was 7.2 (6.3) ng/mL. During the 8943 person-years of follow-up, 164 (17 %) men died. In unadjusted analysis, each unit increase in serum anti-mullerian hormone level was associated with a 13 % lower risk of death (HR = 0.87; 95 %CI = 0.83-0.92). In multivariable models, the inverse association between serum anti-mullerian hormone levels and mortality remained significant (HR = 0.94; 95 %CI = 0.90-0.98) and was independent of confounding variables. Similarly, individuals in the highest quartile had significantly lower risk of death as compared to individuals in the lowest quartile (unadjusted HR = 0.13, 95 %CI = 0.07-0.25; adjusted HR = 0.36, 95 %CI = 0.16-0.81). We found an independent and inverse association between serum anti-mullerian hormone levels and all-cause mortality in men. The mechanism underlying this association is unknown. Further studies are needed to validate our findings in men and to examine this association in women.
authors: Department of Internal Medicine, University of Tennessee College of Medicine at Chattanooga, Chattanooga, TN, USA. rqayyum@jhmi.edu.|Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA. rqayyum@jhmi.edu.
authors: Rehan
authors: http://orcid.org/0000-0003-3086-8014
authors: R
authors: Qayyum
authors: Department of Internal Medicine, University of Tennessee College of Medicine at Chattanooga, Chattanooga, TN, USA.
authors: Sana
authors: S
authors: Akbar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D054304:Anti-Mullerian Hormone / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013739:Testosterone / Q000097:blood; D055815:Young Adult
chemical_list: D013739:Testosterone; D054304:Anti-Mullerian Hormone
keywords: Anti-mullerian hormone; Men; Mortality; NHANES