Body Composition and Serum Anti-Müllerian Hormone Levels in Euthyroid Caucasian Women With Hashimoto Thyroiditis

Abstract

ObjectiveWomen with Hashimoto thyroiditis (HT) are characterized by increased incidence of infertility and disturbances in body composition. Serum anti-Müllerian hormone (AMH), which reflects functional ovarian reserve, is decreased in women with HT and it be related to body mass. The aim of the present study was to investigate the relation between serum levels of AMH and body composition in HT compared to control group.Patients and MethodsWe examined 85 euthyroid women: 39 subjects with HT and 46 control women. Body composition was analysed by dual-energy X-ray absorptiometry and with bioimpedance method. Serum concentrations of AMH, leptin, TSH, thyroid hormones were assessed.ResultsWe observed lower serum concentration of AMH in women with HT in comparison to the control group (p=0.01), but without differences in serum concentration of leptin between studied groups (p=0.28). Women with HT were characterized by higher %body fat (p=0.01) estimated with bioimpedance method without differences in BMI, android and gynoid fat mass and visceral adipose tissue (VAT) mass estimated with DXA method when compared to the control group (all p>0.05). We found a negative relationship between serum concentration of AMH and %body fat (r=-0.38,p=0.03) in women with HT. Additionally, in HT group, the relationship between serum levels of AMH and leptin was not statistically significant (r=0.01,p=0.96). We observed a relationship between serum concentration of leptin and BMI, %body fat mass, android, gynoid and VAT mass in HT and in the control group (all p<0.01).ConclusionsWomen with HT are characterized by lower levels of AMH and it is associated with higher fat mass, independently of serum levels of leptin.

Evaluation of anti-Müllerian hormone in pre-menopausal women stratified according to thyroid function, autoimmunity and age

“…The former finding could be linked to the time-related reduction in TV on L-T4 treatment [ 30 ], and the latter to genetic factors [ 23 ]. Only Adamska et al [ 20 ] reported TV in their study on AMH; they found no difference in TV between women with Hashimoto’s thyroiditis and control women of same median age of 26 years, the median value being 10 ml, which is only slightly higher than that found in our women (8 ml). This difference in TV could be explained by the difference in age-range, goitre control by means of L-T4 treatment, and regional differences in iodine intake.…”

“…Finally, in women aged 20-40 years, Kucukler et al [ 27 ] reported a significant inverse correlation between AMH and age both in those with normal thyroid function and in those with newly diagnosed sub-clinical or overt thyroid dysfunction. By contrast, on evaluating AMH levels in women aged 18-35 years, Adamska et al [ 20 ] did not find any age-related changes in AMH in either 46 normal or 39 euthyroid TPOAb-positive women in this age-range.…”

“…A significant negative correlation between BMI or waist circumference and AMH was reported in a Turkish study involving a small number of women with normal thyroid function and sub-clinical or overt hypothyroidism when they were cumulatively evaluated [ 26 ]. Adamska et al [ 20 ] also reported a negative correlation between serum AMH and the percentage of body fat mass, as estimated by bioimpedance analysis, in a group of 39 women with Hashimoto’s thyroiditis, but not in 46 control women. By contrast, no correlation between AMH and BMI was observed in two older studies [ 11 , 18 ].…”

“…The mechanisms underlying this inverse correlation between AMH and BMI are still unclear, though the impact of insulin resistance on follicular development in PCOS has been speculated [ 29 ]. Interestingly, it has been suggested that the inverse relationship between serum levels of AMH and BMI could be the result of hormone dilution due to higher blood volume in women with elevated BMI [ 20 ].…”

“…A literature search conducted at the end of 2021 identified several papers in which AMH and thyroid function and/or autoimmunity were evaluated. The studies involved had mainly been conducted in centres for human reproduction, and no agreement emerged on the role of the thyroid in AMH secretion or indirectly on the ovarian reserve [11][12][13][14][15][16][17][18][19][20][21]. In 2015, a study involving a large number of women undergoing screening for infertility, in which a cross-sectional retrospective analysis of AMH, free-thyroxine (f-T4), TSH and thyroperoxidase antibody (TPOAb) was conducted, concluded that thyroid autoimmunity and function were not associated with low ovarian reserve [12].…”