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. 2020 Nov;7(1):e000439.
doi: 10.1136/lupus-2020-000439.

Anti-Müllerian hormone in African-American women with systemic lupus erythematosus

Meghan Angley  1 , Jessica B Spencer  2 , S Sam Lim  3   4 , Penelope P Howards  3
Affiliations

Anti-Müllerian hormone in African-American women with systemic lupus erythematosus

Meghan Angley et al. Lupus Sci Med. 2020 Nov.

Abstract

Objective: Women with SLE may experience ovarian insufficiency or dysfunction due to treatment or disease effects. Anti-Müllerian hormone (AMH), a marker of ovarian reserve, has been examined in small populations of women with SLE with conflicting results. To date, these studies have included very few African-American women, the racial/ethnic group at greatest risk of SLE.

Methods: We enrolled African-American women aged 22-40 years diagnosed with SLE after age 17 from the Atlanta Metropolitan area. Women without SLE from the same area were recruited from a marketing list for comparison. AMH was measured in serum using the Ansh Labs assay (Webster, Texas, USA). We considered AMH levels <1.0 ng/mL and AMH <25th percentile of comparison women as separate dichotomous outcomes. Log-binomial regression models estimating prevalence ratios were adjusted for age, body mass index and hormonal contraception use in the previous year.

Results: Our sample included 83 comparison women without SLE, 68 women with SLE and no history of cyclophosphamide (SLE/CYC-) and 11 women with SLE and a history of cyclophosphamide treatment (SLE/CYC+). SLE/CYC+ women had a greater prevalence of AMH <1.0 ng/mL compared with women without SLE (prevalence ratio (PR): 2.90, 95% CI: 1.29 to 6.51). SLE/CYC- women were also slightly more likely to have AMH <1.0 ng/mL (PR: 1.62, 95% CI: 0.93 to 2.82) than comparison women. Results were similar when considering AMH <25th percentile by age of comparison women.

Conclusions: Treatment with CYC is associated with low AMH in African-American women with SLE. SLE itself may also be associated with reduced AMH, but to a lesser extent.

Keywords: cyclophosphamide; inflammation; lupus erythematosus; systemic.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Predicted AMH values (ng/mL) by age with 95% CIs. AMH. anti-Müllerian hormone; CYC, cyclophosphamide.
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