Abstract
Objective: The purpose of this study was to assess the serum anti-Mullerian hormone (AMH) levels and related factors in overweight and obese girls during their prepubertal, pu-bertal, and post-menarcheal periods.
Method: Anthropometric measurements, physical examination features, laboratory findings, and serum AMH levels were evaluated in girls with overweight and obesity admitted be-tween March and April 2021 in the Pediatric Endocrinology Clinic at Erciyes University Faculty of Medicine.
Results: Serum AMH levels were evaluated in a total of 40 girls: 12 (30%) prepubertal, 12 (30%) pubertal, and 16 (40%) post-menarcheal. Their ages were 7.7 (±1.7), 10.3 (±2.1), and 15.4 (±1.8) years, and their serum AMH measurements were 2.4 (±2.4), 2.1 (±1.1), and 4.6 (±3.7) ng/mL, respectively. The serum AMH levels between prepubertal and pubertal girls and post-menarcheal girls were significantly different (p=0.020). There was no significant difference when compared to normal AMH levels for their age (p=0.722).
In the age-adjusted correlation analysis of the patients, no significant relationship was found between AMH levels and anthropometric measurements (height, weight, weight-SD, BMI, BMI-SD, neck circumference-SD, mid-upper arm circumference-SD, waist circumference-SD, waist-to-height ratio, and waist-to-hip ratio). A positive correlation was found only in height-SD (r=0.334, p=0.038).
Conclusion: The study found that the serum AMH levels of girls with overweight and obesi-ty increased moderately during the prepubertal period, specifically several years preceding puberty, slightly decreased during the onset of puberty, and significantly increased during the post-menarcheal period, like healthy girls.
Keywords: Anti-Mullerian hormone, body mass index, body measurements, obesity, puber-ty
Copyright and license
Copyright © 2024 The author(s). This is an open-access article published by Aydın Pediatric Society under the terms of the Creative Commons Attribution License (CC BY) which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.
How to cite
References
- Broekmans FJ, Visser JA, Laven JS, Broer SL, Themmen AP, Fauser BC. Anti-Müllerian hormone and ovarian dysfunction. Trends Endocrinol Metab. 2008;19:340-7. https://doi.org/10.1016/j.tem.2008.08.002
- La Marca A, Broekmans FJ, Volpe A, Fauser BC, Macklon NS; ESHRE Special In-terest Group for Reproductive Endocrinology--AMH Round Table. Anti-Mullerian hormone (AMH): what do we still need to know? Hum Reprod. 2009;24:2264-75. https://doi.org/10.1093/humrep/dep210
- Visser JA, de Jong FH, Laven JSE, Themmen AP. Anti-Müllerian hormone: a new marker for ovarian function. Reproduction. 2006;131:1-9. https://doi.org/10.1530/rep.1.00529
- van Rooij IA, Broekmans FJ, te Velde ER, et al. Serum anti-Müllerian hormone lev-els: a novel measure of ovarian reserve. Hum Reprod. 2002;17:3065-71. https://doi.org/10.1093/humrep/17.12.3065
- Lee MM, Donahoe PK, Hasegawa T, et al. Mullerian inhibiting substance in humans: normal levels from infancy to adulthood. J Clin Endocrinol Metab. 1996;81:571-6. https://doi.org/10.1210/jcem.81.2.8636269
- Hagen CP, Aksglaede L, Sørensen K, et al. Serum levels of anti-Müllerian hormone as a marker of ovarian function in 926 healthy females from birth to adulthood and in 172 Turner syndrome patients. J Clin Endocrinol Metab. 2010;95:5003-10. https://doi.org/10.1210/jc.2010-0930
- Hagen CP, Aksglaede L, Sørensen K, et al. Individual serum levels of anti-Müllerian hormone in healthy girls persist through childhood and adolescence: a longitudinal cohort study. Hum Reprod. 2012;27:861-6. https://doi.org/10.1093/humrep/der435
- Kelsey TW, Wright P, Nelson SM, Anderson RA, Wallace WH. A validated model of serum anti-müllerian hormone from conception to menopause. PLoS One. 2011;6:e22024. https://doi.org/10.1371/journal.pone.0022024
- Lie Fong S, Visser JA, Welt CK, et al. Serum anti-müllerian hormone levels in healthy females: a nomogram ranging from infancy to adulthood. J Clin Endocrinol Metab. 2012;97:4650-5. https://doi.org/10.1210/jc.2012-1440
- Lashen H, Dunger DB, Ness A, Ong KK. Peripubertal changes in circulating antimül-lerian hormone levels in girls. Fertil Steril. 2013;99:2071-5. https://doi.org/10.1016/j.fertnstert.2013.01.139
- Jeffery A, Streeter AJ, Hosking J, Wilkin TJ, Nelson SM. Anti-Müllerian hormone in children: a ten-year prospective longitudinal study (EarlyBird 39). J Pediatr Endo-crinol Metab. 2015;28:1153-62. https://doi.org/10.1515/jpem-2014-0517
- Freeman EW, Gracia CR, Sammel MD, Lin H, Lim LC, Strauss JF. Association of an-ti-mullerian hormone levels with obesity in late reproductive-age women. Fertil Steril. 2007;87:101-6. https://doi.org/10.1016/j.fertnstert.2006.05.074
- Piouka A, Farmakiotis D, Katsikis I, Macut D, Gerou S, Panidis D. Anti-Mullerian hormone levels reflect severity of PCOS but are negatively influenced by obesity: re-lationship with increased luteinizing hormone levels. Am J Physiol Endocrinol Metab. 2009;296:E238-43. https://doi.org/10.1152/ajpendo.90684.2008
- Hart R, Doherty DA, Norman RJ, et al. Serum antimullerian hormone (AMH) levels are elevated in adolescent girls with polycystic ovaries and the polycystic ovarian syndrome (PCOS). Fertil Steril. 2010;94:1118-21. https://doi.org/10.1016/j.fertnstert.2009.11.002
- Lefebvre T, Dumont A, Pigny P, Dewailly D. Effect of obesity and its related meta-bolic factors on serum anti-Müllerian hormone concentrations in women with and without polycystic ovaries. Reprod Biomed Online. 2017;35:325-30. https://doi.org/10.1016/j.rbmo.2017.05.013
- Kim JY, Tfayli H, Michaliszyn SF, Lee S, Nasr A, Arslanian S. Anti-Müllerian Hor-mone in obese adolescent girls with polycystic ovary syndrome. J Adolesc Health. 2017;60:333-9. https://doi.org/10.1016/j.jadohealth.2016.10.015
- Sahmay S, Usta T, Erel CT, et al. Is there any correlation between amh and obesity in premenopausal women? Arch Gynecol Obstet. 2012;286:661-5. https://doi.org/10.1007/s00404-012-2363-x
- Oldfield AL, Kazemi M, Lujan ME. Impact of obesity on Anti-Mullerian Hormone (AMH) levels in women of reproductive age. J Clin Med. 2021;10:3192. https://doi.org/10.3390/jcm10143192
- Korkmaz Ö, Gökşen D, Özen S, Darcan Ş. Is anti-Mullerian hormone an indicator of potential polycystic ovary syndrome in prepubertal girls with simple obesity? Turk J Pediatr. 2016;58:406-12. https://doi.org/10.24953/turkjped.2016.04.010
- Li XJ, Wang H, Lu DY, et al. Anti-Müllerian hormone accelerates pathological pro-cess of insulin resistance in polycystic ovary syndrome patients. Horm Metab Res. 2021;53:504-11. https://doi.org/10.1055/a-1499-7718
- Wiweko B, Indra I, Susanto C, Natadisastra M, Hestiantoro A. The correlation be-tween serum AMH and HOMA-IR among PCOS phenotypes. BMC Res Notes. 2018;11:114. https://doi.org/10.1186/s13104-018-3207-y
- Neyzi O, Bundak R, Gökçay G, et al. Reference values for weight, height, head cir-cumference, and body mass index in Turkish children. J Clin Res Pediatr Endocrinol. 2015;7:280-93. https://doi.org/10.4274/jcrpe.2183
- Mazıcıoğlu MM, Hatipoğlu N, Oztürk A, Ciçek B, Ustünbaş HB, Kurtoğlu S. Waist circumference and mid-upper arm circumference in evaluation of obesity in children aged between 6 and 17 years. J Clin Res Pediatr Endocrinol. 2010;2:144-50. https://doi.org/10.4274/jcrpe.v2i4.144
- Hatipoğlu N, Doğan S, Mazıcıoğlu MM, Kurtoğlu S. Relationship between neck cir-cumference and non-alcoholic fatty liver disease in childhood obesity. J Clin Res Pe-diatr Endocrinol. 2016;8:32-9. https://doi.org/10.4274/jcrpe.2313
- Smith MB, Ho J, Ma L, et al. Longitudinal antimüllerian hormone and its correlation with pubertal milestones. F S Rep. 2021;2:238-44. https://doi.org/10.1016/j.xfre.2021.02.001
- Zeng X, Huang Y, Zhang M, et al. Anti-Müllerian hormone was independently asso-ciated with central obesity but not with general obesity in women with PCOS. Endocr Connect. 2022;11:e210243. https://doi.org/10.1530/EC-21-0243
- Moy V, Jindal S, Lieman H, Buyuk E. Obesity adversely affects serum anti-müllerian hormone (AMH) levels in Caucasian women. J Assist Reprod Genet. 2015;32:1305-11. https://doi.org/10.1007/s10815-015-0538-7
- Utriainen P, Jääskeläinen J, Voutilainen R. Serum anti-müllerian hormone concentra-tions in prepubertal girls with and without premature adrenarche: the influence of body mass index. Horm Res Paediatr. 2010;74:207-11. https://doi.org/10.1159/000282113
- Siow Y, Kives S, Hertweck P, Perlman S, Fallat ME. Serum Müllerian-inhibiting sub-stance levels in adolescent girls with normal menstrual cycles or with polycystic ova-ry syndrome. Fertil Steril. 2005;84:938-44. https://doi.org/10.1016/j.fertnstert.2005.02.052
- Czech I, Partyka M, Drosdzol-Cop A. Does body mass index affect anti-mullerian hormone levels in girls and adolescents? Ginekol Pol. 2023;94:524-6. https://doi.org/10.5603/GP.a2023.0013
- Savas-Erdeve S, Sagsak E, Keskin M, Cetinkaya S, Aycan Z. AMH levels in girls with various pubertal problems. J Pediatr Endocrinol Metab. 2017;30:333-5. https://doi.org/10.1515/jpem-2016-0217
- Hagen CP, Mouritsen A, Mieritz MG, et al. Circulating AMH reflects ovarian mor-phology by magnetic resonance imaging and 3D ultrasound in 121 healthy girls. J Clin Endocrinol Metab. 2015;100:880-90. https://doi.org/10.1210/jc.2014-3336