The independent associations of anti-Mullerian hormone and estradiol levels over the menopause transition with lipids/lipoproteins: The Study of Women's health Across the Nation

Background: The menopause transition (MT) is linked to adverse changes in lipids/lipoproteins. However, the related contributions of anti-Mullerian hormone (AMH) and estradiol (E2) are not clear. Objective: To evaluate the independent associations of premenopausal AMH and E2 levels and their changes with lipids/lipoproteins levels [total cholesterol (TC), triglyceride (TG), low-density lipopro-tein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), apolipoprotein B (apoB) and apolipoprotein A-1 (apoA-1)] over the MT.Methods: SWAN participants who transitioned to menopause without exogenous hormone use, hys-terectomy, or bilateral oophorectomy with data available on both exposure and outcomes when they were premenopausal until the 1st visit postmenopausal were studied.Results: The study included 1,440 women (baseline-age:mean +/- SD= 47.4 +/- 2.6) with data available from up to 9 visits (1997-2013). Lower premenopausal levels and greater declines in AMH were in-dependently associated with greater TC and HDL-C, whereas lower premenopausal levels and greater declines in E2 were independently associated with greater TG and apo B and lower HDL-C. Greater declines in AMH were independently associated with greater apoA-1, and greater declines in E2 were independently associated with greater TC and LDL-C.Conclusions: AMH and E2 and their changes over the MT relate differently to lipids/lipoproteins profile in women during midlife. Lower premenopausal and/or greater declines in E2 over the MT were associated with an atherogenic lipid/lipoprotein profile. On the other hand, lower premenopausal AMH and/or greater declines in AMH over the MT were linked to higher apo A-1 and HDL-C; the later found previously to be related to a greater atherosclerotic risk after menopause.(c) 2022 National Lipid Association. Published by Elsevier Inc. All rights reserved.

Automated summary

The study evaluated the independent associations of AMH and E2 levels and their changes with lipids/lipoproteins levels in menopausal women. Lower premenopausal AMH levels and greater declines in AMH were associated with higher total cholesterol and high-density lipoprotein cholesterol, while lower premenopausal E2 levels and greater declines in E2 were associated with higher triglyceride and apolipoprotein B levels and lower high-density lipoprotein cholesterol. These findings are important for understanding lipid metabolism changes during the menopausal transition.