Longitudinal antimüllerian hormone and its correlation with pubertal milestones

OBJECTIVE: To examine the changes in AMH levels longitudinally over time and their relationship with both body composition, particularly abdominal adiposity, and milestones of pubertal development in female children. DESIGN: Secondary analysis of a prospective, longitudinal study. SETTING: University affiliated research center and laboratories. PATIENT(S): Eighty-nine females were examined between 1990 and 2015 to study child growth and development. INTERVENTION(S): Demographic, anthropometric, growth, and pubertal milestone data with serum samples stored and subsequently analyzed for AMH. MAIN OUTCOME MEASURE(S): Longitudinal change in AMH and predicted AMH levels based on body composition, age, and pubertal milestones including, pubarche, thelarche, and menarche. RESULT(S): Natural log-transformed AMH (AMH(log)) levels appeared to have a nonlinear relationship with age, decreasing between 10 and 14 years of age, increasing until 16 years. A mixed effect linear model demonstrated that increased abdominal adiposity (waist/height ratio, WHtR) was significantly associated with the predicted increased AMH(log) levels (β=1.37). As females progressed through the Tanner stages, the model predicted decreasing AMH(log) values when adjusting for age and WHtR. CONCLUSION(S): Declining AMH levels during puberty may not be reflective of diminished ovarian reserve as observed in adults, but may suggest a permissive role of AMH in the activation of the hypothalamic-pituitary-ovarian axis.