FRI423 Obesity And Adiposity Are Associated With Decreased Anti-Mullerian Hormone (AMH) Levels In A Reproductive Aged Latina/LatinX Population
Authors: Schon Samantha , Jiang Charley , Ferrell Emily Lenk , Valbuena Felix , Neff Lisa , Carnethon Mercedes , Marsh Erica Elizabeth 
Published: October 2023

Abstract
Disclosure: S. Schon: None. C. Jiang: None. E.L. Ferrell: None. F. Valbuena: None. L. Neff: Other; Self; Eli Lilly & Company, Dr. Neff is currently an employee and shareholder of Eli Lilly and Company, which has no affiliation with this work. At the onset of the study, she was employed by Northwestern University Feinberg Sch. M. Carnethon: None. E.E. Marsh: Consulting Fee; Self; Pfizer, Inc.
Objective: Research suggests that obesity has an adverse effect on ovarian reserve, as assessed by AMH. Prior studies have explored this association predominantly in non-Hispanic Caucasian and African American cohorts. In addition, few studies have utilized metrics beyond BMI to characterize adiposity. The objective of this study was to examine the association of obesity/adiposity with AMH in a Latina/LatinX population using multiple measures of obesity/adiposity.
Materials & Methods: This cross-sectional study utilized data from the Environment, Leiomyomas, Latinas, and Adiposity Study (ELLAS). ELLAS is a prospective longitudinal cohort study following Latina/LatinX females for 5 years. ELLAS used community based participatory research principles for engagement. Participants were between the ages of 21-50 at time of enrollment. Data from the first study visit were utilized for analysis. Assessment included anthropometrics, measurement of body composition using bioelectrical impedance analysis (BIA) (Tanita MC-280U) and serum AMH (pico-AMH assay, Ansh Labs). The association between BMI on AMH was assessed as a continuous and categorical outcome. Adiposity based on body fat %, and visceral adiposity index (VAI) was studied in relation to AMH using linear regression models. Statistical associations were determined using Chi-square, Wilcoxon rank-sum and linear or logistic regression as appropriate.
Results: 621 women completed the first study visit and had BMI and AMH data available. BIA data was available on 591 participants. The mean age of participants was 37.5 ± 7.0 years. The mean BMI was 30.1 ± 6.8 kg/m2, with 261 (42%) of participants classified as having obesity by BMI (≥30 kg/m2). 214 women (34.5%) reported irregular menses and 89 reported currently taking hormonal contraception (HC) (14.3%). BMI was negatively associated with AMH (β=-0.055 p=0.014), however, this association was no longer significant after adjusting for age. Similarly, body fat % and VAI were also negatively associated with AMH (β=-0.058 p= 0.013, and β=-0.256 p&lt;0.001), however this association was attenuated after adjusting for age. When the analysis was restricted to women not taking HC and with regular menses (n=290), higher BMI remained negatively associated with AMH after adjusting for age (β=-0.04, p=0.003). Similarly, higher body fat % and VAI were also negatively associated with AMH after adjusting for age (β=-0.04, p=0.005, and β=-0.090 p=0.009). Highest lifetime BMI was also associated with AMH after adjusting for age (β=-0.03, p=0.03).
Conclusions: Among a cohort of Latina/LatinX females with normal menses, obesity and adiposity as assessed by BMI, body fat % and visceral adiposity index were negatively associated with AMH. This suggests that excess adiposity may compromise ovarian reserve and demonstrates the importance of assessing baseline gynecologic characteristics.
Presentation: Friday, June 16, 2023