Introduction:
Anti-Müllerian hormone (AMH) is primarily known for its role in sexual differentiation during embryogenesis, and ovarian follicle development in premenopausal women. Furthermore, recent research suggests that higher AMH levels are associated with a lower occurrence of (subclinical) cardiovascular disease (CVD) in both women and men. However, these studies only included a small variety of subclinical CVD measures. We aimed to investigate whether circulating AMH is associated with a wider range of subclinical CVD measures in middle-aged and older men.
Hypothesis:
Higher AMH levels are associated with more favorable levels of subclinical CVD measures.
Methods:
We analyzed data from 371 male participants (aged 40-80 years at recruitment) from a Dutch population-based study. AMH was measured in serum samples obtained at recruitment using the Elecsys
®
AMH assay (Roche Diagnostics). At baseline we measured carotid intima-media thickness (cIMT)(μm), pulse wave velocity (PWV)(m/s) and aorta diameter (cm), and calculated Framingham risk score predictions. We investigated associations between AMH (μg/L) levels, both continuously and in tertiles, and these outcomes using linear regression models adjusted for known CVD risk factors, free testosterone, free estradiol and dihydroepiandrosterone sulphate (DHEAS). Sensitivity analyses comprised exclusion of prevalent diabetes and CVD cases.
Results:
Higher AMH levels were associated with a lower cIMT at baseline (β
continuousAMH
= -6.3, 95%CI: -10.7, -1.9; β
T2vsT1
= -30.6, 95%CI: -60.2, -0.9; β
T3vsT1
= -39.8, 95%CI: -70.1, -9.6). We observed no statistically significant associations between AMH and the remaining outcomes, but effect estimates indicated that higher AMH levels may be associated with lower PWV (β
continuousAMH
= -0.02, 95%CI: -0.10, 0.05), and lower Framingham risk score predictions (β
continuousAMH
= -0.004, 95%CI: -0.008, 0.000). Exclusion of prevalent diabetes and CVD cases did not change our conclusions.
Conclusions:
The results of this study suggest that higher AMH levels are associated with a lower cIMT in middle-aged and older men. Based on our results we cannot exclude a possible relation between circulating AMH levels and other measures of subclinical cardiovascular disease.
Ambulatory blood pressure adds little to Framingham Risk Score for the primary prevention of cardiovascular disease in older men: secondary analysis of observational study data