AMH as Predictor of Premature Ovarian Insufficiency: A Longitudinal Study of 120 Turner Syndrome Patients

Stine Aa Lunding; Lise Aksglæde; Richard A Anderson; Katharina M Main; Anders Juul; Casper P Hagen; Anette T Pedersen

doi:10.1210/jc.2015-1621

AMH as Predictor of Premature Ovarian Insufficiency: A Longitudinal Study of 120 Turner Syndrome Patients

Stine Aa Lunding, Lise Aksglæde, Richard A Anderson, Katharina M Main, Anders Juul, Casper P Hagen, Anette T Pedersen

Department of Clinical Medicine

48 Citations (Scopus)

Abstract

Context: The majority of Turner syndrome (TS) patients suffer from accelerated loss of primordial follicles. Low circulating levels of anti-Müllerian hormone (AMH) may predict the lack of spontaneous puberty in prepubertal girls and imminent premature ovarian insufficiency (POI) in TS women with preserved ovarian function. Objectives: To evaluate the association between circulatingAMHand ovarian status in TS patients. Design: Longitudinal observational cohort study. Setting: Tertiary referral center for pediatric and gynecologic endocrinology. Participants: A total of 120 TS patients, aged 0 to 48 years. Main Outcome Measures: Longitudinal measurements of AMH, FSH, LH, estradiol, and inhibin B according to age, karyotype (45,X; 45,X/46,XX mosaicism; miscellaneous karyotypes), and ovarian status (group 0, prepubertal; group 1, never ovarian function; group 2, ongoing ovarian function; and group 3, loss of ovarian function). Results: Ovarian status was highly associated with the TS karyotype: spontaneous puberty-45,X (three of 44 patients), 45,X/46,XX (15 of 17), miscellaneous (17 of 42); and POI-45,X (three of three), 45,X/46,XX (one of 15), and miscellaneous (eight of 17). AMH was associated with ovarian status (eg, group 1, 2 pmol/L; vs group 2, 19 pmol/L; P=.001). AMH-4 pmol/L (corresponding to-2 SD) predicted absent puberty in prepubertal girls and POI in adolescent and adult patients. Conclusion: The majority of women with mosaic karyotype 45,X/46,XX had ongoing ovarian function in early adulthood. AMH=-2 SD predicted failure to enter puberty in young TS girls and imminent POI in adolescent and adult TS patients.

Original language	English
Journal	Journal of Clinical Endocrinology and Metabolism
Volume	100
Issue number	7
Pages (from-to)	E1030-8
Number of pages	9
ISSN	0021-972X
DOIs	https://doi.org/10.1210/jc.2015-1621
Publication status	Published - 1 Jul 2015

Keywords

Adolescent
Adult
Anti-Mullerian Hormone
Biomarkers
Child
Child, Preschool
Female
Humans
Infant
Infant, Newborn
Longitudinal Studies
Middle Aged
Primary Ovarian Insufficiency
Prognosis
Turner Syndrome
Young Adult

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@article{ea3d4442eaf942d8b8ae392c0001ccec,

title = "AMH as Predictor of Premature Ovarian Insufficiency: A Longitudinal Study of 120 Turner Syndrome Patients",

abstract = "Context: The majority of Turner syndrome (TS) patients suffer from accelerated loss of primordial follicles. Low circulating levels of anti-M{\"u}llerian hormone (AMH) may predict the lack of spontaneous puberty in prepubertal girls and imminent premature ovarian insufficiency (POI) in TS women with preserved ovarian function. Objectives: To evaluate the association between circulatingAMHand ovarian status in TS patients. Design: Longitudinal observational cohort study. Setting: Tertiary referral center for pediatric and gynecologic endocrinology. Participants: A total of 120 TS patients, aged 0 to 48 years. Main Outcome Measures: Longitudinal measurements of AMH, FSH, LH, estradiol, and inhibin B according to age, karyotype (45,X; 45,X/46,XX mosaicism; miscellaneous karyotypes), and ovarian status (group 0, prepubertal; group 1, never ovarian function; group 2, ongoing ovarian function; and group 3, loss of ovarian function). Results: Ovarian status was highly associated with the TS karyotype: spontaneous puberty-45,X (three of 44 patients), 45,X/46,XX (15 of 17), miscellaneous (17 of 42); and POI-45,X (three of three), 45,X/46,XX (one of 15), and miscellaneous (eight of 17). AMH was associated with ovarian status (eg, group 1, 2 pmol/L; vs group 2, 19 pmol/L; P=.001). AMH-4 pmol/L (corresponding to-2 SD) predicted absent puberty in prepubertal girls and POI in adolescent and adult patients. Conclusion: The majority of women with mosaic karyotype 45,X/46,XX had ongoing ovarian function in early adulthood. AMH=-2 SD predicted failure to enter puberty in young TS girls and imminent POI in adolescent and adult TS patients.",

keywords = "Adolescent, Adult, Anti-Mullerian Hormone, Biomarkers, Child, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Longitudinal Studies, Middle Aged, Primary Ovarian Insufficiency, Prognosis, Turner Syndrome, Young Adult",

author = "Lunding, {Stine Aa} and Lise Aksgl{\ae}de and Anderson, {Richard A} and Main, {Katharina M} and Anders Juul and Hagen, {Casper P} and Pedersen, {Anette T}",

year = "2015",

month = jul,

day = "1",

doi = "10.1210/jc.2015-1621",

language = "English",

volume = "100",

pages = "E1030--8",

journal = "Journal of Clinical Endocrinology and Metabolism",

issn = "0021-972X",

publisher = "Oxford University Press",

number = "7",

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TY - JOUR

T1 - AMH as Predictor of Premature Ovarian Insufficiency

T2 - A Longitudinal Study of 120 Turner Syndrome Patients

AU - Lunding, Stine Aa

AU - Aksglæde, Lise

AU - Anderson, Richard A

AU - Main, Katharina M

AU - Juul, Anders

AU - Hagen, Casper P

AU - Pedersen, Anette T

PY - 2015/7/1

Y1 - 2015/7/1

N2 - Context: The majority of Turner syndrome (TS) patients suffer from accelerated loss of primordial follicles. Low circulating levels of anti-Müllerian hormone (AMH) may predict the lack of spontaneous puberty in prepubertal girls and imminent premature ovarian insufficiency (POI) in TS women with preserved ovarian function. Objectives: To evaluate the association between circulatingAMHand ovarian status in TS patients. Design: Longitudinal observational cohort study. Setting: Tertiary referral center for pediatric and gynecologic endocrinology. Participants: A total of 120 TS patients, aged 0 to 48 years. Main Outcome Measures: Longitudinal measurements of AMH, FSH, LH, estradiol, and inhibin B according to age, karyotype (45,X; 45,X/46,XX mosaicism; miscellaneous karyotypes), and ovarian status (group 0, prepubertal; group 1, never ovarian function; group 2, ongoing ovarian function; and group 3, loss of ovarian function). Results: Ovarian status was highly associated with the TS karyotype: spontaneous puberty-45,X (three of 44 patients), 45,X/46,XX (15 of 17), miscellaneous (17 of 42); and POI-45,X (three of three), 45,X/46,XX (one of 15), and miscellaneous (eight of 17). AMH was associated with ovarian status (eg, group 1, 2 pmol/L; vs group 2, 19 pmol/L; P=.001). AMH-4 pmol/L (corresponding to-2 SD) predicted absent puberty in prepubertal girls and POI in adolescent and adult patients. Conclusion: The majority of women with mosaic karyotype 45,X/46,XX had ongoing ovarian function in early adulthood. AMH=-2 SD predicted failure to enter puberty in young TS girls and imminent POI in adolescent and adult TS patients.

AB - Context: The majority of Turner syndrome (TS) patients suffer from accelerated loss of primordial follicles. Low circulating levels of anti-Müllerian hormone (AMH) may predict the lack of spontaneous puberty in prepubertal girls and imminent premature ovarian insufficiency (POI) in TS women with preserved ovarian function. Objectives: To evaluate the association between circulatingAMHand ovarian status in TS patients. Design: Longitudinal observational cohort study. Setting: Tertiary referral center for pediatric and gynecologic endocrinology. Participants: A total of 120 TS patients, aged 0 to 48 years. Main Outcome Measures: Longitudinal measurements of AMH, FSH, LH, estradiol, and inhibin B according to age, karyotype (45,X; 45,X/46,XX mosaicism; miscellaneous karyotypes), and ovarian status (group 0, prepubertal; group 1, never ovarian function; group 2, ongoing ovarian function; and group 3, loss of ovarian function). Results: Ovarian status was highly associated with the TS karyotype: spontaneous puberty-45,X (three of 44 patients), 45,X/46,XX (15 of 17), miscellaneous (17 of 42); and POI-45,X (three of three), 45,X/46,XX (one of 15), and miscellaneous (eight of 17). AMH was associated with ovarian status (eg, group 1, 2 pmol/L; vs group 2, 19 pmol/L; P=.001). AMH-4 pmol/L (corresponding to-2 SD) predicted absent puberty in prepubertal girls and POI in adolescent and adult patients. Conclusion: The majority of women with mosaic karyotype 45,X/46,XX had ongoing ovarian function in early adulthood. AMH=-2 SD predicted failure to enter puberty in young TS girls and imminent POI in adolescent and adult TS patients.

KW - Adolescent

KW - Adult

KW - Anti-Mullerian Hormone

KW - Biomarkers

KW - Child

KW - Child, Preschool

KW - Female

KW - Humans

KW - Infant

KW - Infant, Newborn

KW - Longitudinal Studies

KW - Middle Aged

KW - Primary Ovarian Insufficiency

KW - Prognosis

KW - Turner Syndrome

KW - Young Adult

U2 - 10.1210/jc.2015-1621

DO - 10.1210/jc.2015-1621

M3 - Journal article

C2 - 25978111

SN - 0021-972X

VL - 100

SP - E1030-8

JO - Journal of Clinical Endocrinology and Metabolism

JF - Journal of Clinical Endocrinology and Metabolism

IS - 7

ER -

AMH as Predictor of Premature Ovarian Insufficiency: A Longitudinal Study of 120 Turner Syndrome Patients

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Keywords

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