Reproductive and Lifestyle Determinants of Anti-Mullerian Hormone in a Large Population-based Study
Reproductive and Lifestyle Determinants of Anti-Mullerian Hormone in a Large Population-based Study
复制标题
DOI：
10.1210/jc.2012-4228
复制
发表时间：
2013-05-01
影响因子：
5.8
通讯作者：
van der Schouw, Y. T.
中科院分区：
文献类型：
--
作者：
Dolleman, M.;Verschuren, W. M. M.;van der Schouw, Y. T.
背景：抗苗勒管激素（AMH）浓度反映了卵巢的衰老，并被认为是绝经年龄（AMP）的一个有用的预测因子。假设AMH低于临界阈值对应于卵泡耗竭，这导致绝经。有了这个阈值，就可以对AMP进行理论预测。从人口研究中观察到的AMP支持AMH作为一个predicter of menopause.Objective：本研究的目的是探讨是否以前的AMH和AMP之间的关系是有效的，使用一个更大的dataset.Setting：AMH测量27 563名妇女参加生育诊所的预测比较。研究设计：根据这些数据，采用稳健的回归分析构建年龄相关AMH变化模型。低生育力妇女的AMP数据来自基于人群的Prosthes-European癌症和营养前瞻性研究（Prosthes-EPIC）队列（n = 2249）。通过构建AMH福尔斯下降到临界阈值以下的年龄的概率分布，并使用最大似然法将其拟合到Prostaglandin-EPIC绝经年龄数据，估计了这样的阈值。主要结果：主要结果是观察到的AMP和预测的AMP之间的一致性。为了得到符合Prosthet-EPIC数据的AMH预测AMP的分布，我们发现，不同年龄段女性的临界抗苗勒氏管激素阈值不同，年龄特异性抗苗勒氏管激素低的女性阈值较低，而年龄特异性抗苗勒氏管激素高的女性阈值较高（平均值0.075 ng/mL;四分位数间距0.038-0.15 ng/mL）。这种不同的AMH绝经阈值是一个新的和生物学上合理的发现。AMH检测不到（
Context: Anti-Mullerian hormone (AMH) concentration reflects ovarian aging and is argued to be a useful predictor of age at menopause (AMP). It is hypothesized that AMH falling below a critical threshold corresponds to follicle depletion, which results in menopause. With this threshold, theoretical predictions of AMP can be made. Comparisons of such predictions with observed AMP from population studies support the role for AMH as a forecaster of menopause.Objective: The objective of the study was to investigate whether previous relationships between AMH and AMP are valid using a much larger data set.Setting: AMH was measured in 27 563 women attending fertility clinics. StudyDesign: From these data a model of age-related AMH change was constructed using a robust regression analysis. Data on AMP from subfertile women were obtained from the population-based Prospect-European Prospective Investigation into Cancer and Nutrition (Prospect-EPIC) cohort (n = 2249). By constructing a probability distribution of age at which AMH falls below a critical threshold and fitting this to Prospect-EPIC menopausal age data using maximum likelihood, such a threshold was estimated.Main Outcome: The main outcome was conformity between observed and predicted AMP.Results: To get a distribution of AMH-predicted AMP that fit the Prospect-EPIC data, we found the critical AMH threshold should vary among women in such a way that women with low age-specific AMH would have lower thresholds, whereas women with high age-specific AMH would have higher thresholds (mean 0.075 ng/mL; interquartile range 0.038-0.15 ng/mL). Such a varying AMH threshold for menopause is a novel and biologically plausible finding. AMH became undetectable (