Objective

To examine the changes in AMH levels longitudinally over time and their relationship with both body composition, particularly abdominal adiposity, and milestones of pubertal development in female children.

Design

Secondary analysis of a prospective, longitudinal study.

Setting

University affiliated research center and laboratories.

Patients

Eighty-nine females were examined between 1990 and 2015 to study child growth and development.

Interventions

Demographic, anthropometric, growth, and pubertal milestone data with serum samples stored and subsequently analyzed for AMH.

Main outcome measures

Longitudinal change in AMH and predicted AMH levels based on body composition, age, and pubertal milestones including, pubarche, thelarche, and menarche.

Results

Natural log-transformed AMH (AMH_log) levels appeared to have a nonlinear relationship with age, decreasing between 10 and 14 years of age, increasing until 16 years. A mixed effect linear model demonstrated that increased abdominal adiposity (waist/height ratio, WHtR) was significantly associated with the predicted increased AMH_log levels (β=1.37). As females progressed through the Tanner stages, the model predicted decreasing AMH_log values when adjusting for age and WHtR.

Conclusions

Declining AMH levels during puberty may not be reflective of diminished ovarian reserve as observed in adults, but may suggest a permissive role of AMH in the activation of the hypothalamic-pituitary-ovarian axis.