SERUM TRIGLYCERIDES AND TOTAL CHOLESTEROL ARE ASSOCIATED WITH ANTIMULLERIAN HORMONE LEVELS

Abstract

To determine if serum lipid levels (high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol (LDL), triglycerides (TG), or total cholesterol (TC)) are associated with antimullerian (AMH) levels in a reproductive aged population of women from the Midwest in order to identify potential modifiable targets to improve ovarian reserve. A cohort of 199 women between the ages of 18 and 44 were enrolled into a cross-sectional cohort study. Women with regular menstrual cycles were included, women who were currently pregnant or had a history of major chronic illness or ovarian surgery were excluded. Fasting blood was drawn and stored at -80 degrees celsius for batched analysis. AMH values were measured using the Roche cobas e411 analyzer. The lipid values were measured using Roche cobas 6000 automated platform with a c501 analyzer using FDA-approved kits from Roche Diagnostics, with the exception of LDL cholesterol, which was calculated by the Friedewald equation. Bivariate statistics were used to assess associations between lipid and AMH levels. SPSS v26 was used for analysis. This study was approved by the Washington University IRB. On average, participants were 30.9 ± 6.7 years and had a body mass index of 28.3±7.1 kg/m2. Most of the study participants were white (n=136, 68%) and approximately one third were black (n=60, 30%). AMH values were not normally distributed and were negatively skewed. The median AMH level was 2.5ng/mL (IQR 1.44-4.01). The median TC and TG were significantly higher in those with AMH levels <1ng/mL compared to those with AMH levels ≥1ng/mL (p = 0.023 and p = 0.002, respectively). When stratified by BMI greater than or less than 25, TG levels were higher in the AMH <1ng/mL group compared to the AMH ≥ 1ng/mL group (p=0.007). LDL and TC levels were also higher in the BMI < 25 group with a trend towards significance (p=0.055, p=0.070). In the BMI ≥ 25 group, TG levels were higher in the AMH <1 group compared to the AMH > 1 group with a trend towards significance (p=0.057). Our data suggest that for healthy, reproductive aged women from the Midwest, total cholesterol and triglycerides could be potential targets to modify with lifestyle changes and/or medication that could potentially improve AMH. With a healthy BMI, lower AMH values were associated with higher LDL, TG, and TC levels. Perhaps women with a lower BMI who have a diet that is high in fats have impacted their ovarian reserve. Future interventional studies are needed.