Sangeeta Nair1, James C Slaughter2, James G Terry1, Duke Appiah3, Imo Ebong4, Erica Wang5, David S Siscovick6, Barbara Sternfeld7, Pamela J Schreiner3, Cora E Lewis8, Edmond K Kabagambe9, Melissa F Wellons10. 1. Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University, 2525 West End Avenue, Suite 600, Nashville, TN 37203, United States. 2. Department of Biostatistics, Vanderbilt University School of Medicine, 2525 West End Avenue, Suite 1100, Nashville, TN 37203, United States. 3. Division of Epidemiology and Community Health, University of Minnesota, 1300 S 2nd St., Suite 300, Minneapolis, MN 55454, United States. 4. Loma Linda University Medical Center Transplantation Institute, 25865 Barton Road, Suite 101, Loma Linda, CA 92354, United States. 5. Department of Obstetrics and Gynecology, Cedars Sinai Medical Center, San Diego, CA 90048, United States. 6. New York Academy of Medicine, New York, NY 10029, United States. 7. Kaiser Permanente, Division of Research, Epidemiology and Prevention, 2000 Broadway, Oakland, CA 94612, United States. 8. Division of Preventive Medicine, Department of Medicine, University of Alabama Birmingham, 1717 11th Avenue South, Room 614, Birmingham, AL 35205, United States. 9. Department of Medicine and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University, 2525 West End Avenue, Suite 600, Nashville, TN 37203, United States. 10. Department of Medicine and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University, 2525 West End Avenue, Suite 600, Nashville, TN 37203, United States. Electronic address: Melissa.Wellons@Vanderbilt.edu.
Abstract
OBJECTIVE: AMH is associated with menopausal timing in several studies. In contrast to prior studies that were restricted to women with regular cycles, our objective was to examine this association in women with either regular or irregular menstrual cycles. METHODS: CARDIA is a longitudinal, population-based study that recruited adults ages 18-30 when it began in 1985-1986. AMH was measured in serum stored in 2002-2003. Natural menopause was assessed by survey in 2005-2006 and 2010-2011. RESULTS: Among 716 premenopausal women, median [25th, 75th] AMH was 0.77 [0.22-2.02]ng/dL at a median age of 42 [39-45] years. Twenty-nine percent of the women (n=207) reported natural menopause during 9 years of follow up. In fully adjusted discrete-time hazard models, a 0.5 ng/dL AMH decrement was associated with higher risk of menopause (p<0.001). Hazard ratios varied with time since AMH measurement. The HR (95% CI) for menopause was 8.1 (2.5-26.1) within 0-3 years and 2.3 (1.7-3.3) and 1.6 (1.3-2.1) for 3-6 and 6-9 years, respectively. When restricted to women with regular menses, results were similar (e.g., HR=6.1; 95% CI: 1.9-20.0 for 0-3 years). CONCLUSION: AMH is independently associated with natural menopause. AMH appears most useful in identifying women at risk of menopause in the near future (within 3 years of AMH measurement).
OBJECTIVE: AMH is associated with menopausal timing in several studies. In contrast to prior studies that were restricted to women with regular cycles, our objective was to examine this association in women with either regular or irregular menstrual cycles. METHODS: CARDIA is a longitudinal, population-based study that recruited adults ages 18-30 when it began in 1985-1986. AMH was measured in serum stored in 2002-2003. Natural menopause was assessed by survey in 2005-2006 and 2010-2011. RESULTS: Among 716 premenopausal women, median [25th, 75th] AMH was 0.77 [0.22-2.02]ng/dL at a median age of 42 [39-45] years. Twenty-nine percent of the women (n=207) reported natural menopause during 9 years of follow up. In fully adjusted discrete-time hazard models, a 0.5 ng/dL AMH decrement was associated with higher risk of menopause (p<0.001). Hazard ratios varied with time since AMH measurement. The HR (95% CI) for menopause was 8.1 (2.5-26.1) within 0-3 years and 2.3 (1.7-3.3) and 1.6 (1.3-2.1) for 3-6 and 6-9 years, respectively. When restricted to women with regular menses, results were similar (e.g., HR=6.1; 95% CI: 1.9-20.0 for 0-3 years). CONCLUSION: AMH is independently associated with natural menopause. AMH appears most useful in identifying women at risk of menopause in the near future (within 3 years of AMH measurement).
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