The association between anti-Müllerian hormone and vitamin 25(OH)D serum levels and polycystic ovarian syndrome in adolescent females

Abstract

Background High anti-Müllerian hormone (AMH) levels and 25-hydroxyvitamin D [25(OH)D] deficiency have been associated with polycystic ovarian syndrome (PCOS) in adult women, and implicated in its pathogenesis. Herein we determined if the level of both AMH and 25(OH)D are altered in adolescent females with clinical features of PCOS. Methods This is a cross-sectional study utilizing a retrospective chart review of 128 patients aged 12–20 referred to an academic adolescent gynecology and endocrinology clinic for an evaluation of suspected PCOS. Unadjusted comparisons of AMH and 25(OH)D distributions between subjects with and without PCOS were performed using the Wilcoxon Rank Sum test. Quantile regression was used to compare the median AMH and 25(OH)D between subject groups; adjusting for race, ethnicity, BMI, insurance type, age, and season when bloodwork was performed. Results Seventy-four subjects were classified as having PCOS by meeting ≥2 of the three Rotterdam diagnostic criteria, and 47 subjects met only one Rotterdam diagnostic criteria, and were used as the comparative non-PCOS group. There were statistically significant unadjusted differences in median levels of AMH and 25(OH)D. In the adjusted analyses, median AMH was significantly higher in the PCOS group compared to the non-PCOS group (+ 2.39 ng/mL, 95% CI 0.43, 4.35, p = 0.018); 25(OH)D was significantly lower in the PCOS group (− 9.01 ng/mL, 95% CI -14.49, − 3.53 p = 0.001). In our sample, adolescents in both groups had insufficient 25(OH)D level (22 ng/mL) and elevated BMI (32.2 kg/m2). Conclusions Adolescents with PCOS display high levels of AMH and low 25(OH)D levels. Since traditional clinical markers of PCOS may be physiologic in adolescents, AMH and 25(OH)D may be used as surrogate markers of PCOS risk in adolescents.

Mechanisms Involved in the Relationship between Vitamin D and Insulin Resistance: Impact on Clinical Practice

“…Women with PCOS and hirsutism have been found to have lower 25(OH)D levels than BMI-matched controls [169,172], which may be explained by an association of vitamin D with androgens or SHBG [170,173]. In a cross-sectional study in adolescents, participants with PCOS had higher levels of AMH and lower levels of 25(OH)D than in the group without PCOS [174]. They concluded that since traditional clinical markers of PCOS may be physiological in adolescents, AMH and 25(OH)D can be used as surrogate markers of PCOS risk in this population.…”

Dietary supplementation for female infertility: Recent advances in the nutritional therapy for premature ovarian insufficiency

“…Its active form, 1,25-dihydroxy vitamin D 3 is localized in many organs, such as kidney, liver, brain and ovary ( Xu et al, 2016 ). In the female reproductive system, vitamin D can regulate anti-Müllerian hormone (AMH) secretion in the granulosa cells and consequently affect FSH level ( Simpson et al, 2020 ). However, its role in POI pathogenesis is controversial as some claimed it did not influence pathophysiological process of POI, while others reported vitamin D deficiency was correlated with coagulation and was a primary factor for POI due to follicular dysgenesis and aromatase level decrease ( Kebapcilar et al, 2013 ; Ersoy et al, 2016 ).…”

Sun Exposure Score and Vitamin D Levels in Moroccan Women of Childbearing Age

“…Recently, vitamin D has been implicated in reproductive health and pregnancy outcomes [ 12 , 13 ]. Clinical studies have shown that vitamin D supplementation can lower androgen levels, lower anti-Mullerian hormone (AMH) levels [ 14 , 15 ], normalize the metabolic profile, and regularize periods in women with polycystic ovarian syndrome (PCOS) [ 16 , 17 ]. In fact, low serum 25(OH)D concentrations have been linked to problems of infertility [ 18 , 19 ], endometriosis [ 20 ], polycystic ovary syndrome (PCOS) [ 16 , 17 , 21 , 22 ], as well as adverse pregnancy outcomes, including spontaneous abortions [ 23 ], gestational diabetes [ 24 , 25 ], bacterial vaginosis [ 26 ], preeclampsia [ 27 , 28 ], neonatal hypocalcemia [ 29 ], prematurity, and low birth weight [ 30 ], as well as fetal and infant growth disorders [ 31 ].…”