The Journal of clinical endocrinology and metabolism · 2026
Anti-Mullerian Hormone and Collagen Type I C-telopeptide Predict Fast, Imminent Bone Loss in Early Perimenopause: SWAN.
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Shieh Albert, Karlamangla Arun S, Gossiel Fatma, Eastell Richard, Burnett-Bowie Sherri-Ann, Greendale Gail A
Аннотация
CONTEXT: Faster menopause-related bone mineral density (BMD) decline predicts more fractures.
OBJECTIVE: Examine anti-Mullerian hormone (AMH) and collagen type I C-telopeptide (CTX) as predictors of fast, imminent BMD loss (BMD decline rate, over the next 1-2 years, ≥mean, annual menopause rate).
DESIGN: Repeated measures modified Poisson regression estimated the associations of early perimenopausal levels of (1) AMH or CTX (in separate models), or (2) AMH and CTX (in a single model) with fast, imminent BMD loss.
SETTING: Study of Women's Health Across the Nation (community-based cohort).
PARTICIPANTS: A total of 436 early perimenopausal women.
MAIN OUTCOME MEASURES: Fast, imminent BMD loss (at lumbar spine [LS], femoral neck [FN], or total hip [TH]).
RESULTS: In separate models, adjusted for age, body mass index, cigarette use, race/ethnicity and study site, lesser AMH or greater CTX individually related to greater fast, imminent BMD loss risk. As predictors in a single model, lesser AMH and greater CTX remained independently associated with fast, imminent BMD loss. Per SD decrement in log-transformed AMH, fast BMD decline risk was 45% (LS), 17% (FN), and 26% (TH) greater (each P < .0001). Per SD increment in log-transformed CTX, fast BMD loss risk was 35% (LS), 23% (FN), and 34% (TH) greater (each P < .0001). Model areas under the curve was greater for models with AMH and CTX vs those for models with AMH or CTX individually (P < .001 for each BMD site-specific comparison).
CONCLUSION: Combining AMH and CTX affords stronger prediction of fast, imminent BMD loss than using AMH or CTX individually.
OBJECTIVE: Examine anti-Mullerian hormone (AMH) and collagen type I C-telopeptide (CTX) as predictors of fast, imminent BMD loss (BMD decline rate, over the next 1-2 years, ≥mean, annual menopause rate).
DESIGN: Repeated measures modified Poisson regression estimated the associations of early perimenopausal levels of (1) AMH or CTX (in separate models), or (2) AMH and CTX (in a single model) with fast, imminent BMD loss.
SETTING: Study of Women's Health Across the Nation (community-based cohort).
PARTICIPANTS: A total of 436 early perimenopausal women.
MAIN OUTCOME MEASURES: Fast, imminent BMD loss (at lumbar spine [LS], femoral neck [FN], or total hip [TH]).
RESULTS: In separate models, adjusted for age, body mass index, cigarette use, race/ethnicity and study site, lesser AMH or greater CTX individually related to greater fast, imminent BMD loss risk. As predictors in a single model, lesser AMH and greater CTX remained independently associated with fast, imminent BMD loss. Per SD decrement in log-transformed AMH, fast BMD decline risk was 45% (LS), 17% (FN), and 26% (TH) greater (each P < .0001). Per SD increment in log-transformed CTX, fast BMD loss risk was 35% (LS), 23% (FN), and 34% (TH) greater (each P < .0001). Model areas under the curve was greater for models with AMH and CTX vs those for models with AMH or CTX individually (P < .001 for each BMD site-specific comparison).
CONCLUSION: Combining AMH and CTX affords stronger prediction of fast, imminent BMD loss than using AMH or CTX individually.