Anti-Müllerian Hormone Levels Are Associated With Skeletal Maturity in Adolescent Girls: A Longitudinal Study

The role of anti-Müllerian hormone (AMH), a potential marker of the hypothalamic-pituitary-ovarian axis, is not well established in adolescent females. Typical epidemiologic studies use secondary sexual characteristics or chronological age as predictors for AMH. Skeletal maturity, an indicator of bone development, however, has not been examined in association with AMH in adolescent females. This study aimed to examine patterns of change in AMH levels in relation to skeletal maturity in healthy adolescents from the Fels Longitudinal Study.

A longitudinal study was conducted on 88 females (212 observations) between the ages of 8 and 18. AMH levels were analyzed using ELISA from stored frozen serum samples. Skeletal age from hand-wrist radiographs, as well as demographics, anthropometrics, and cardiometabolic risk factors, were included in the analysis. In the stepwise linear mixed-effects regression models, log-transformed AMH (AMH_log) was regressed on relative skeletal age, the skeletal maturity indicator calculated as chronological age minus skeletal age. Chronological age modeled as a cubic function, adiposity measures, and cardiometabolic factors such as fasting glucose were included as covariates.

Skeletal maturity significantly predicted lower AMH_log (β = -0.073, SE = 0.032, p = 0.02). Serum glucose levels were significantly associated with decreases in AMH_log (β = -0.008, SE = 0.004, p = 0.04). Chronological age was not significantly associated with AMH_log.

Our study showed a negative relationship between AMH and skeletal age relative to chronological age. This study highlights that AMH and skeletal maturity provide correlated information on growth and pubertal status in adolescent females.