Association between serum 25-hydroxyvitamin D and antimüllerian hormone levels in a cohort of African-American women

Abstract

ObjectiveTo examine the association between serum 25-hydroxyvitamin D [25(OH)D] and ovarian reserve as measured by antimüllerian hormone (AMH). DesignCross-sectional study. SettingDetroit, Michigan area. SubjectsData were obtained from a prospective cohort of self-identified Black/African-American women aged 23-35 years at the time of enrollment (N=1593), had no prior diagnosis of polycystic ovary syndrome (PCOS), were not currently pregnant, and were not missing AMH or 25(OH)D measures. ExposureSerum 25(OH)D. Main outcome measureSerum AMH was the main outcome. Linear regression was used to examine the associations between categorical 25(OH)D (<12 ng/mL, 12-<20, 20-<30, ≥30) and continuous natural log-transformed AMH. Associations between 25(OH)D and high (upper 10th percentile: >7.8 ng/mL) or low AMH (<0.7 ng/mL) were estimated with logistic regression. Models were adjusted for age, age-squared, BMI, hormonal contraceptive use, smoking, and exercise. ResultsThe 25(OH)D levels were low; 70% of participants were below 20 ng/mL. In fully-adjusted models, compared to 25(OH)D levels <12 ng/mL, those with 25(OH)D levels of 12-<20, 20-<30 and ≥30 ng/mL had an AMH level that was 7% (95% CI: -4, 20) , 7% (95% CI: -6, 22), or 11% higher (95% CI: -7, 34), respectively. Moreover, these groups had a lower odds of having low AMH (OR[95% CI): 0.63 (0.40, 0.99), 0.60 (0.34, 1.07), 0.76 (0.35, 1.65), respectively, and the highest category of 25(OH)D had a higher odds of having high AMH, (OR [95% CI]: 1.42 [0.74, 2.72]). Exclusion of participants with either irregular cycles or very high AMH (>25 ng/mL), did not alter the associations. ConclusionTaken together, these results indicate that higher levels of 25(OH)D are associated with a slightly higher AMH, a lower odds of low AMH, and a higher odds of high AMH. This evidence is weak, however, since only a small percentage of participants had high 25(OH)D. Future studies should examine populations with a wide distribution of 25(OH)D levels (both high and low), with a clinical trial design, or with longitudinal measures of both 25(OH)D and AMH.