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Low anti-Mullerian hormone in reproductive age is associated with MASLD in midlife
Katherine M Cooper1, Melissa Wellons2, James G Terry3
1Department of Medicine, UMass Chan Medical School, Worcester, Massachusetts, USA.
Background:
Anti-Mullerian hormone (AMH) is produced by ovarian follicles and is clinically reflective of reproductive aging. AMH has been associated with the severity of steatohepatitis in those with known metabolic dysfunction-associated steatotic liver disease (MASLD), although its association with prevalent MASLD is not known.
Methods:
Using the multicenter longitudinal Coronary Artery Risk Development in Young Adults cohort, we evaluated the association of low AMH levels in healthy young women with subsequent MASLD in midlife, assessed by CT scan 10 years later. Alternate causes of steatosis were excluded, and multivariable logistic regression was adjusted for confounding metabolic risk factors.
Results:
Among 585 eligible participants, 50 (8.5%) had MASLD. MASLD was more common among participants with low AMH (14% vs. 7%, p=0.03). Adjusted for baseline covariates, low AMH was associated with 2.50-fold higher odds of prevalent MASLD (95% CI: 1.18-5.28, p=0.02). The findings persisted after adjusting for both baseline and change in metabolic profiles (OR: 2.36, 95% CI: 1.05-5.27, p=0.04). The relationship between low AMH and MASLD was not mediated by body mass index (p=0.82) or visceral adipose tissue volume (p=0.14).
Conclusions:
Low AMH levels in reproductive-aged women conferred a more than 2-fold higher odds of prevalent MASLD in midlife, independent of metabolic comorbidities. AMH levels may therefore serve as a valuable marker of MASLD risk in young women.
Insights
Low Anti-Mullerian hormone (AMH) levels in young women are linked to a higher risk of developing metabolic dysfunction-associated steatotic liver disease (MASLD) later in life. This association is independent of metabolic factors, suggesting AMH as a potential early risk marker for MASLD.
Area of Science:
- Reproductive endocrinology
- Hepatology
- Metabolic disease research
Background:
- Anti-Mullerian hormone (AMH) reflects ovarian reserve and reproductive aging.
- AMH is linked to steatohepatitis severity in patients with metabolic dysfunction-associated steatotic liver disease (MASLD).
- The association between AMH levels and prevalent MASLD is currently unknown.
Purpose of the Study:
- To investigate the association between low AMH levels in healthy young women and the subsequent development of MASLD in midlife.
- To determine if AMH can serve as an early predictor of MASLD risk.
Main Methods:
- Utilized the Coronary Artery Risk Development in Young Adults (CARDIA) cohort study.
- Assessed low AMH levels in young women and tracked subsequent MASLD diagnosis via CT scan 10 years later.
- Excluded alternative causes of steatosis and employed multivariable logistic regression, adjusting for metabolic risk factors.
Main Results:
- Among 585 participants, 8.5% developed MASLD.
- Low AMH was associated with a 2.50-fold increased odds of prevalent MASLD (p=0.02), even after adjusting for metabolic profiles (OR: 2.36, p=0.04).
- This relationship was not mediated by body mass index or visceral adipose tissue volume.
Conclusions:
- Low AMH levels in reproductive-aged women predict a significantly higher risk of midlife MASLD.
- AMH may be a valuable, independent biomarker for identifying young women at risk for MASLD.
- Early identification via AMH could facilitate timely interventions for MASLD prevention.
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