Decline in anti-Müllerian hormone was associated with increased risk for CVD, according to recently published findings.
Recent studies had previously shown that early menopause in women is associated with elevated risk for CVD.
“Proposed mechanisms of this association include the sudden decrease of estrogen exposure, with putative effects of vasculature and cardiac function,” Annelien C. de Kat, MD, of the department of reproductive medicine at University Medical Center Utrecht in the Netherlands, and colleagues wrote. “Although this theory is often accepted as fact, the available evidence regarding the role of estrogens remains contradictory. It is, therefore, plausible that other factors contributing to the increased CVD risk associated with menopause are still unknown.”
De Kat and colleagues evaluated women (n = 3,108) from the Netherlands aged 20 to 60 years at baseline. Anti-Müllerian hormone (AMH) was measured in plasma samples (n = 8,507). Hospital discharge registries were used to obtain data on CVD, stroke and CHD.
At the end of the 20-year follow-up, 8.2% of participants had CVD, 4.9% had CHD and 2.6% participants had a stroke.
Each additional 1-ng/mL lower logAMH level was associated with a higher risk of CVD (HR = 1.21; 95% CI, 1.07-1.36) and CHD (HR = 1.25; 95% CI, 1.08-1.46) after adjustment for age, smoking, oral contraceptive use, BMI, menopausal status, postmenopausal hormone therapy use, diastolic BP, total cholesterol, HDL and glucose levels, the researchers wrote. Each additional 1-mg/mL per year decrease of logAMH was associated with a significantly higher risk for CVD (HR = 1.46; 95% CI, 1.14-1.87) and CHD (HR = 1.56; 95%, 1.15-2.12).
No association was found between AMH and stroke.
“This study is the first to identify an independent relationship between AMH levels and AMH decline rate with CVD in women,” the researchers wrote. “The potential role of AMH in [CV] health may provide a missing link to the CVD risk associated with menopause, for which an unequivocal explanation is still lacking. We eagerly await future studies to confirm and elaborate on our results for the transition to clinical practice.” – by Cassie Homer
Disclosure: de Kat reports no relevant financial disclosures. One researcher reports receiving fees and grants from Ferring BV, Gedeon Richter, Merck Serono and Roche.