LONGITUDINAL ANTI-MULLERIAN HORMONE AND ITS CORRELATION WITH PUBERTAL MILESTONES

Structured Abstract Objective To examine the change in AMH levels longitudinally over time and their relationship with both body composition, particularly abdominal adiposity, and milestones of pubertal development. Design Secondary analysis of a prospective, longitudinal study Setting University affiliated research center and laboratories Patients Eighty-nine females examined between 1990-2015 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. Results Natural log transformed AMH (AMHlog) levels appeared to have a non-linear 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 predicted increased AMHlog levels (β=1.37, p = 0.035). As females progressed through the Tanner stages, the model predicted decreasing AMHlog values (breast development, p = 0.031; pubic hair development, p = 0.064) when adjusting for age and WHtR. Conclusions Declining AMH levels during puberty may not be reflective of diminished ovarian reserve as observed in adults, rather may suggest a permissive role of AMH in activation of the hypothalamic-pituitary-ovarian axis that remains to be further explored.