Anti-Müllerian hormone level may predict rate of bone loss during menopause transition
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Women with lower levels of anti-Müllerian hormone may experience greater bone loss during menopause transition, according to study findings published in the Journal of Bone and Mineral Research.
“In women going through the menopause transition, we do not know if menopause-related bone loss has begun or is imminent,” Arun S. Karlamangla, PhD, MD, professor of medicine and geriatrics at the David Geffen School of Medicine, University of California, Los Angeles, told Healio. “A finding of a low anti-Müllerian hormone (AMH) level in the blood makes bone loss more likely.”
Karlamangla and colleagues analyzed data from the Study of Women’s Health Across the Nation (SWAN), a prospective cohort study of women aged 42 to 52 years who were premenopausal or early perimenopausal at baseline and were not prescribed hormone therapy. Bone mineral density measurements and fasting blood draws were collected at baseline and follow-up visits at intervals of 1 to 2 years. Researchers conducted two analyses, one measuring the annual rate of BMD decline 3 to 4 years after an AMH measurement in 888 women, and the second measuring the percentage of peak BMD lost 2 to 3 years after AMH measurement in 924 women.
The mean annual decline in BMD 3 to 4 years after AMH measurement was 1.1% in the lumbar spine and 0.9% in the femoral neck. The mean percentage of peak BMD lost 2 to 3 years after AMH measurement was 2.8% in the lumbar spine and 2.3% in the femoral neck.
At 3 to 4 years after AMH measurement, women with 50% less serum AMH had a 0.14% faster decline in lumbar spine BMD and 0.11% faster decline in femoral neck BMD (P < .001 for both). In analysis stratified for menopause transition stage, a lower AMH level was associated with a faster decline in BMD for women in premenopause and early perimenopause, but not for those in late perimenopause.
Women with 50% less serum AMH had an additional 0.37% loss in lumbar spine BMD and 0.27% loss in femoral neck BMD from baseline to 2 to 3 years follow-up (P < .001 for both). After stratification for menopause transition stage, a 50% lower AMH level was associated with a 0.22% greater loss in lumbar spine BMD in premenopause, a 0.43% greater loss during early perimenopause and a 0.5% greater loss in late perimenopause from baseline to 2 to 3 years follow-up (P < .001 for all). Each 50% decrease in AMH level was associated with a 0.32% greater loss in femoral neck BMD in early perimenopause (P < .001) and 0.37% greater decline in late perimenopause (P = .006), but no significant decline was observed in women during premenopause.
Karlamangla said the findings show that measuring AMH levels may help predict how much ongoing or future bone loss a woman in menopause transition may experience and can help providers with implementing interventions to slow the BMD decline.
“Clinical trials of interventions that slow the bone loss in women who are at risk of losing the most bone mass before much bone has been lost are needed,” Karlamangla said.
For more information:
Arun S. Karlamangla, PhD, MD, can be reached at akarlamangla@mednet.ucla.edu.
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