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. 2016 Nov;106(6):1446-1452.
doi: 10.1016/j.fertnstert.2016.07.009. Epub 2016 Jul 28.

Antimüllerian hormone among women with and without type 1 diabetes: the Epidemiology of Diabetes Interventions and Complications Study and the Michigan Bone Health and Metabolism Study

Catherine Kim  1 , Carrie Karvonen-Gutierrez  2 , Shengchun Kong  3 , Valerie Arends  4 , Michael Steffes  4 , Daniel S McConnell  2 , John F Randolph Jr  5 , Siobán D Harlow  2
Affiliations

Antimüllerian hormone among women with and without type 1 diabetes: the Epidemiology of Diabetes Interventions and Complications Study and the Michigan Bone Health and Metabolism Study

Catherine Kim et al. Fertil Steril. 2016 Nov.

Abstract

Objective: To compare concentrations of antimüllerian hormone (AMH) in women with and without type 1 diabetes.

Design: Cross-sectional analysis of longitudinal studies, adjusting for repeated measures.

Setting: Not applicable.

Patient(s): Women aged 30-45 years who had not undergone oophorectomy, hysterectomy, or natural menopause at the time of AMH measurement were included (n = 376 in the Michigan Bone Health and Metabolism Study and n = 321 in the Epidemiology of Interventions and Complications Study). Linear mixed regression was used to evaluate whether AMH concentrations differed by diabetes status, adjusting for repeated measurements of AMH within individual women, body mass index, smoking status, and oral contraceptive use.

Intervention(s): None.

Main outcome measure(s): Concentrations of AMH.

Result(s): In unadjusted comparisons, women with and without diabetes had similar median AMH values before 35 years of age, although women with type 1 diabetes had a lower proportion of women with elevated AMH concentrations (≥5.0 ng/dL). After adjustment for covariates and multiple observations per woman, log AMH concentrations were significantly lower among women with type 1 diabetes compared with women without diabetes (β-coefficient -1.27, 95% confidence interval [-2.18, -0.36] in fully adjusted models) before 35 years of age.

Conclusion(s): Before 35 years of age, women with type 1 diabetes have lower AMH levels than women without diabetes. Further investigation is needed to determine the etiologies of this difference and how it may contribute to reproductive disorders among women with type 1 diabetes.

Keywords: Ovarian hormones; reproductive endocrinology; type 1 diabetes; women's health.

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Conflict of interest statement

There are no conflicts of interest relevant to this article. Assay kits for the measurement of AMH in the Michigan Bone Health and Metabolism Study were provided at no charge by Beckman Coulter. Dr. Kong was an employee at Purdue University during the completion of the manuscript. The DCCT/EDIC has been supported by U01 Cooperative Agreement grants (1982–93, 2011–2016), and contracts (1982–2011) with the Division of Diabetes Endocrinology and Metabolic Diseases of the National Institute of Diabetes and Digestive and Kidney Disease (current grant numbers U01 DK094176 and U01 DK094157), and through support by the National Eye Institute, the National Institute of Neurologic Disorders and Stroke, the Genetic Clinical Research Centers Program (1993–2007), and Clinical Translational Science Center Program (2006-present), Bethesda, Maryland, USA. Additional support for this work was provided by DP3 DK098129. The Michigan Bone Health and Metabolism Study received support from the National Institute of Arthritis and Muscular Skeletal and Skin Diseases (AG051384). SDH gratefully acknowledges use of the services and facilities of the Population Studies Center at the University of Michigan, funded by NICHD Center Grant R24 HD041028.CKG is partially supported by a Claude Pepper Career Development Award.

Figures

Figure 1
Figure 1
Boxplot of AMH concentrations by diabetes status. The bottom and top of the box are the 1st and 3rd quartiles of AMH concentrations and the middle band represents the median.
Figure 2
Figure 2
Mean AMH concentrations by age and diabetes status. Fitting of lines for the MBHMS (Michigan Bone Health and Metabolism Study) and EDIC (Epidemiology of Diabetes Interventions and Complications Study) accounts for multiple observations per woman. The dashed lines indicate the 95% confidence intervals around the median.
See this image and copyright information in PMC

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