ESPEYB18 15. Editors’ Choice (1) (16 abstracts)
15.8. Anti-Mullerian hormone levels and risk of type 2 diabetes in women
Renée MG Verdiesen , N Charlotte Onland-Moret , Carla H van Gils , Rebecca K Stellato , Annemieke MW Spijkerman , H Susan J Picavet , Frank JM Broekmans , WM Monique Verschuren & Yvonne T van der Schouw
Diabetologia, 2021; 64, 375–384.https://link.springer.com/article/10.1007/s00125-020-05302-5#Abs1
The authors measured plasma anti-Müllerian hormone (AMH) levels over 2x 5-year intervals in a prospective cohort study of 3293 healthy women aged 20–59 years at baseline. Lower baseline age-specific AMH levels were associated with a higher risk of Type 2 diabetes (T2D) after a median 20 years follow-up. When AMH trajectories were predicted in each individual, lower plasma AMH levels at younger ages were seen in women who subsequently developed T2D.
AMH is produced by ovarian follicles in the earlier stages of development (small pre-antral to small antral stage follicle). Circulating AMH levels correspond to the size of the total ovarian follicle pool and declining AMH levels represent a marker of reproductive ageing. Therefore, the current findings widen the evidence linking reproductive and metabolic ageing. The authors adjusted the risk models for several key covariates and the results were not confounded by BMI or polycystic ovary syndrome. Women with lower age-specific AMH levels were more likely to be post-menopausal and the T2D association weakened on adjustment for use of hormone replacement therapy, which suggests that the underlying mechanisms involve sex hormone exposures. Estrogens are thought to be protective for T2D and cardiovascular disease, whereas there is recent evidence that testosterone increases the risk of T2D in women, but has directionally opposite effects on T2D risk in men (1). Alternatively, the link between reproductive and metabolic ageing may involve intrinsic cellular ageing processes that are shared across tissues.
Reference: 1. Ruth KS, et al. Using human genetics to understand the disease impacts of testosterone in men and women. Nature Medicine. 2020 Feb;26(2):252–258.
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ESPE Yearbook of Paediatric Endocrinology
ISSN 1662-4009 (Online)
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