Anti-Mullerian Hormone Premenopause Can Predict Bone Loss Risk Later in Life

Arun Karlamangla, MD

New research from the University of California Los Angeles (UCLA) suggests assessments of anti-Mullerian hormone levels could help clinicians predict or detect bone loss among premenopausal women.

With bone loss is a chief concern among aging women, investigators used data from the Study of Women’s Health Across the Nation (SWAN) study, which is supported by the National Institutes of Health, and determined every 50% decrement in anti-Mullerian hormone levels was associated with additional declines in spine bone mineral density (BMD) ranging from 0.22-0.50% among women between premenopausal, perimenopause, and late perimenopause.

“To be able to intervene and reduce the rate and amount of bone loss, we need to know if this loss is imminent or already ongoing,” said the lead investigator Arun Karlamangla, MD, a professor of medicine in the division of geriatrics at the David Geffen School of Medicine at UCLA, in a statement. “We do not reliably know before it actually happens when a woman’s last menstrual period will be, so we cannot tell whether it is time to do something about bone loss.”

Together with a team of colleagues from the David Geffen School of Medicine at UCLA, Karlamangla designed the current study with the intent of assessing potential predictors of bone loss among women during the menopause transition or immediately before entering menopause. With this in mind, investigators conducted their study to test the hypothesis that low circulating levels of anti-Mullerian hormone were associated with future and ongoing bone loss. A multisite, longitudinal prospective cohort study of the menopause transition, the SWAN study provided investigators with data related to more than 3000 women enrolled at 7 sites between January 1996 and December 1997.

Leveraging this data, investigators designed their study to assess the impact of every 50% decrement in anti-Mullerian hormone level in premenopause, early perimenopause, and in late perimenopause with adjustment for age, BMI, race/ethnicity, and study site.

Upon analysis, results indicated each 50% decrement in anti-Mullerian hormone level was associated with a 0.14% per year feaster decline over the next 3-4 years in lumbar spine BMD and a 0.11% per year faster decline in femoral neck BMD (P <.001 for both). In contrast, no association was observed between anti-Mullerian hormone levels in late perimenopause and rate of future BMD decline.

Additionally, results indicated anti-Mullerian hormone levels were also associated with magnitude of ongoing bone loss when measured as a percent of peak BMD lost by end of the next 2-3 years. Further analysis suggested each 50% decrement in anti-Mullerian hormone level was associated with a 0.22% additional loss in spine BMD in premenopause, 0.43% additional loss in early perimenopause, and 0.50% additional loss in late perimenopause (P for all < .001).

“These findings make feasible the designing and testing of midlife interventions to prevent or delay osteoporosis in women,” authors wrote.

This study, “Anti-Mullerian Hormone as Predictor of Future and Ongoing Bone Loss During the Menopause Transition,” was published in the Journal of Bone and Mineral Research.