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Abstract
Objective To determine if ovarian aging as measured by levels of anti-Müllerian hormone (AMH) is associated with pattern of multiple sclerosis (MS) progression in women.
Methods Women with MS and healthy controls were included from a longitudinal research cohort with up to 10 years follow-up. Plasma AMH levels were measured by ELISA for baseline and years 3, 5, and 8–10. Mixed effects logistic and linear regression models were employed, with adjustments for age, disease duration, and other covariables as appropriate.
Results AMH levels were similar (0.98-fold difference, 95% confidence interval [CI] 0.69–1.37, p = 0.87) in women with MS (n = 412, mean age 42.6 years) and healthy controls (n = 180, mean age 44 years). In a multivariable model of women with MS, including adjustments for age, body mass index, and disease duration, 10-fold lower AMH level was associated with 0.43-higher Expanded Disability Status Scale (EDSS) score (95% CI 0.15–0.70, p = 0.003), 0.25-unit worse MS Functional Composite z score (95% CI −0.40 to −0.10, p = 0.0015), and 7.44 mm3 lower cortical gray matter volume (95% CI −14.6 to −0.30; p = 0.041) at baseline. In a multivariable random-intercept–random-slope model using all observations over time, 10-fold decrease in AMH was associated with a 0.27 increase in EDSS (95% CI 0.11–0.43, p = 0.006) and 5.48 mm3 (95% CI 11.3–0.33, p = 0.065) and 4.55 mm3 (95% CI 9.33–0.23, p = 0.062) decreases in total gray and cortical gray matter, respectively.
Conclusion As a marker of ovarian aging, lower AMH levels were associated with greater disability and gray matter loss in women with MS independent of chronological age and disease duration.
Glossary
- AMH=
- anti-Müllerian hormone;
- BMI=
- body mass index;
- CI=
- confidence interval;
- DMT=
- disease-modifying therapy;
- EDSS=
- Expanded Disability Status Scale;
- FSH=
- follicular stimulating hormone;
- GM=
- gray matter;
- MS=
- multiple sclerosis;
- MSFC=
- MS Functional Composite;
- PPMS=
- primary progressive multiple sclerosis;
- RA=
- rheumatoid arthritis;
- SPMS=
- secondary progressive multiple sclerosis
Footnotes
Coinvestigators are listed at links.lww.com/WNL/A126.
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
- Received February 28, 2017.
- Accepted in final form October 2, 2017.
- Copyright © 2017 American Academy of Neurology
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