Low anti-Mullerian hormone in reproductive age is associated with MASLD in midlife.

BACKGROUND

Anti-Mullerian hormone (AMH) is produced by ovarian follicles and is clinically reflective of reproductive aging. AMH has been associated with the severity of steatohepatitis in those with known metabolic dysfunction-associated steatotic liver disease (MASLD), although its association with prevalent MASLD is not known.

METHODS

Using the multicenter longitudinal Coronary Artery Risk Development in Young Adults cohort, we evaluated the association of low AMH levels in healthy young women with subsequent MASLD in midlife, assessed by CT scan 10 years later. Alternate causes of steatosis were excluded, and multivariable logistic regression was adjusted for confounding metabolic risk factors.

RESULTS

Among 585 eligible participants, 50 (8.5%) had MASLD. MASLD was more common among participants with low AMH (14% vs. 7%, p=0.03). Adjusted for baseline covariates, low AMH was associated with 2.50-fold higher odds of prevalent MASLD (95% CI: 1.18-5.28, p=0.02). The findings persisted after adjusting for both baseline and change in metabolic profiles (OR: 2.36, 95% CI: 1.05-5.27, p=0.04). The relationship between low AMH and MASLD was not mediated by body mass index (p=0.82) or visceral adipose tissue volume (p=0.14).

CONCLUSIONS

Low AMH levels in reproductive-aged women conferred a more than 2-fold higher odds of prevalent MASLD in midlife, independent of metabolic comorbidities. AMH levels may therefore serve as a valuable marker of MASLD risk in young women.