Does AMH relate to timing of menopause? results of an individual patient data meta-analysis

Martine Depmann, Marinus J. C. Eijkemans, Simone L. Broer, Fahimeh R. Tehrani, Masoud Solaymani-Dodaran, Fereidoun Azizi, Cornelis B. Lambalk, John F. Randolph, Sioban D. Harlow, Ellen W. Freeman, Mary D. Sammel, W. M. Monique Verschuren, Yvonne T. van der Schouw, Ben W. Mol, Frank J. M. Broekmans

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Context: Anti-Mü llerian hormone (AMH)-based age at menopause predictions remain cumbersome due to predictive inaccuracy. Objective: To perform an individual patient data meta-Analysis, regarding AMH-based menopause prediction. Design: A systematic literature search was performed using PubMed, Embase, and Cochrane databases. Prospective cohort studies regarding menopause prediction using serum AMH levels were selected by consensus discussion. Individual cases were included if experiencing a regular cycle at baseline. Exclusion criteria were hormone use and gynecological surgery. Results: This meta-Analysis included 2596women, and 1077 experiencedmenopause. A multivariable Cox regression analysis assessed time to menopause using age and AMH. AMH predicted time to menopause; however, added value on top of age was poor [age alone: C-statistic, 84%; age + AMH: hazard ratio (HR), 0.66; 95% CI, 0.61 to 0.71; C-statistic, 86%). Moreover, the capacity of AMH to predict early (#45 years) and late menopause (55 years) was assessed. An added effect of AMH was demonstrated for early menopause (age alone: C-statistic 52%; age + AMH: HR, 0.33; 95%, CI 0.24 to 0.45; C-statistic, 80%). A Weibull regression model calculating individual age at menopause revealed that predictive inaccuracy remained present and increased with decreasing age atmenopause. Lastly, a check of nonproportionality of the predictive effect ofAMHdemonstrated a reduced predictive effect with increasing age. onclusion: AMH was a significant predictor of time to menopause and especially of time to early menopause. However, individual predictions of age at menopause demonstrated a limited precision, particularly when concerning early age atmenopause, making clinical application troublesome.
Original languageEnglish
Pages (from-to)3593-3600
JournalJournal of Clinical Endocrinology and Metabolism
Volume103
Issue number10
DOIs
Publication statusPublished - 2018

Cite this

Depmann, M., Eijkemans, M. J. C., Broer, S. L., Tehrani, F. R., Solaymani-Dodaran, M., Azizi, F., ... Broekmans, F. J. M. (2018). Does AMH relate to timing of menopause? results of an individual patient data meta-analysis. Journal of Clinical Endocrinology and Metabolism, 103(10), 3593-3600. https://doi.org/10.1210/jc.2018-00724
Depmann, Martine ; Eijkemans, Marinus J. C. ; Broer, Simone L. ; Tehrani, Fahimeh R. ; Solaymani-Dodaran, Masoud ; Azizi, Fereidoun ; Lambalk, Cornelis B. ; Randolph, John F. ; Harlow, Sioban D. ; Freeman, Ellen W. ; Sammel, Mary D. ; Verschuren, W. M. Monique ; van der Schouw, Yvonne T. ; Mol, Ben W. ; Broekmans, Frank J. M. / Does AMH relate to timing of menopause? results of an individual patient data meta-analysis. In: Journal of Clinical Endocrinology and Metabolism. 2018 ; Vol. 103, No. 10. pp. 3593-3600.
@article{1115b08dccee42ddb073e8cd3b2da078,
title = "Does AMH relate to timing of menopause? results of an individual patient data meta-analysis",
abstract = "Context: Anti-M{\"u} llerian hormone (AMH)-based age at menopause predictions remain cumbersome due to predictive inaccuracy. Objective: To perform an individual patient data meta-Analysis, regarding AMH-based menopause prediction. Design: A systematic literature search was performed using PubMed, Embase, and Cochrane databases. Prospective cohort studies regarding menopause prediction using serum AMH levels were selected by consensus discussion. Individual cases were included if experiencing a regular cycle at baseline. Exclusion criteria were hormone use and gynecological surgery. Results: This meta-Analysis included 2596women, and 1077 experiencedmenopause. A multivariable Cox regression analysis assessed time to menopause using age and AMH. AMH predicted time to menopause; however, added value on top of age was poor [age alone: C-statistic, 84{\%}; age + AMH: hazard ratio (HR), 0.66; 95{\%} CI, 0.61 to 0.71; C-statistic, 86{\%}). Moreover, the capacity of AMH to predict early (#45 years) and late menopause (55 years) was assessed. An added effect of AMH was demonstrated for early menopause (age alone: C-statistic 52{\%}; age + AMH: HR, 0.33; 95{\%}, CI 0.24 to 0.45; C-statistic, 80{\%}). A Weibull regression model calculating individual age at menopause revealed that predictive inaccuracy remained present and increased with decreasing age atmenopause. Lastly, a check of nonproportionality of the predictive effect ofAMHdemonstrated a reduced predictive effect with increasing age. onclusion: AMH was a significant predictor of time to menopause and especially of time to early menopause. However, individual predictions of age at menopause demonstrated a limited precision, particularly when concerning early age atmenopause, making clinical application troublesome.",
author = "Martine Depmann and Eijkemans, {Marinus J. C.} and Broer, {Simone L.} and Tehrani, {Fahimeh R.} and Masoud Solaymani-Dodaran and Fereidoun Azizi and Lambalk, {Cornelis B.} and Randolph, {John F.} and Harlow, {Sioban D.} and Freeman, {Ellen W.} and Sammel, {Mary D.} and Verschuren, {W. M. Monique} and {van der Schouw}, {Yvonne T.} and Mol, {Ben W.} and Broekmans, {Frank J. M.}",
year = "2018",
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language = "English",
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pages = "3593--3600",
journal = "Journal of Clinical Endocrinology and Metabolism",
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Depmann, M, Eijkemans, MJC, Broer, SL, Tehrani, FR, Solaymani-Dodaran, M, Azizi, F, Lambalk, CB, Randolph, JF, Harlow, SD, Freeman, EW, Sammel, MD, Verschuren, WMM, van der Schouw, YT, Mol, BW & Broekmans, FJM 2018, 'Does AMH relate to timing of menopause? results of an individual patient data meta-analysis' Journal of Clinical Endocrinology and Metabolism, vol. 103, no. 10, pp. 3593-3600. https://doi.org/10.1210/jc.2018-00724

Does AMH relate to timing of menopause? results of an individual patient data meta-analysis. / Depmann, Martine; Eijkemans, Marinus J. C.; Broer, Simone L.; Tehrani, Fahimeh R.; Solaymani-Dodaran, Masoud; Azizi, Fereidoun; Lambalk, Cornelis B.; Randolph, John F.; Harlow, Sioban D.; Freeman, Ellen W.; Sammel, Mary D.; Verschuren, W. M. Monique; van der Schouw, Yvonne T.; Mol, Ben W.; Broekmans, Frank J. M.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 103, No. 10, 2018, p. 3593-3600.

Research output: Contribution to journalArticleAcademicpeer-review

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T1 - Does AMH relate to timing of menopause? results of an individual patient data meta-analysis

AU - Depmann, Martine

AU - Eijkemans, Marinus J. C.

AU - Broer, Simone L.

AU - Tehrani, Fahimeh R.

AU - Solaymani-Dodaran, Masoud

AU - Azizi, Fereidoun

AU - Lambalk, Cornelis B.

AU - Randolph, John F.

AU - Harlow, Sioban D.

AU - Freeman, Ellen W.

AU - Sammel, Mary D.

AU - Verschuren, W. M. Monique

AU - van der Schouw, Yvonne T.

AU - Mol, Ben W.

AU - Broekmans, Frank J. M.

PY - 2018

Y1 - 2018

N2 - Context: Anti-Mü llerian hormone (AMH)-based age at menopause predictions remain cumbersome due to predictive inaccuracy. Objective: To perform an individual patient data meta-Analysis, regarding AMH-based menopause prediction. Design: A systematic literature search was performed using PubMed, Embase, and Cochrane databases. Prospective cohort studies regarding menopause prediction using serum AMH levels were selected by consensus discussion. Individual cases were included if experiencing a regular cycle at baseline. Exclusion criteria were hormone use and gynecological surgery. Results: This meta-Analysis included 2596women, and 1077 experiencedmenopause. A multivariable Cox regression analysis assessed time to menopause using age and AMH. AMH predicted time to menopause; however, added value on top of age was poor [age alone: C-statistic, 84%; age + AMH: hazard ratio (HR), 0.66; 95% CI, 0.61 to 0.71; C-statistic, 86%). Moreover, the capacity of AMH to predict early (#45 years) and late menopause (55 years) was assessed. An added effect of AMH was demonstrated for early menopause (age alone: C-statistic 52%; age + AMH: HR, 0.33; 95%, CI 0.24 to 0.45; C-statistic, 80%). A Weibull regression model calculating individual age at menopause revealed that predictive inaccuracy remained present and increased with decreasing age atmenopause. Lastly, a check of nonproportionality of the predictive effect ofAMHdemonstrated a reduced predictive effect with increasing age. onclusion: AMH was a significant predictor of time to menopause and especially of time to early menopause. However, individual predictions of age at menopause demonstrated a limited precision, particularly when concerning early age atmenopause, making clinical application troublesome.

AB - Context: Anti-Mü llerian hormone (AMH)-based age at menopause predictions remain cumbersome due to predictive inaccuracy. Objective: To perform an individual patient data meta-Analysis, regarding AMH-based menopause prediction. Design: A systematic literature search was performed using PubMed, Embase, and Cochrane databases. Prospective cohort studies regarding menopause prediction using serum AMH levels were selected by consensus discussion. Individual cases were included if experiencing a regular cycle at baseline. Exclusion criteria were hormone use and gynecological surgery. Results: This meta-Analysis included 2596women, and 1077 experiencedmenopause. A multivariable Cox regression analysis assessed time to menopause using age and AMH. AMH predicted time to menopause; however, added value on top of age was poor [age alone: C-statistic, 84%; age + AMH: hazard ratio (HR), 0.66; 95% CI, 0.61 to 0.71; C-statistic, 86%). Moreover, the capacity of AMH to predict early (#45 years) and late menopause (55 years) was assessed. An added effect of AMH was demonstrated for early menopause (age alone: C-statistic 52%; age + AMH: HR, 0.33; 95%, CI 0.24 to 0.45; C-statistic, 80%). A Weibull regression model calculating individual age at menopause revealed that predictive inaccuracy remained present and increased with decreasing age atmenopause. Lastly, a check of nonproportionality of the predictive effect ofAMHdemonstrated a reduced predictive effect with increasing age. onclusion: AMH was a significant predictor of time to menopause and especially of time to early menopause. However, individual predictions of age at menopause demonstrated a limited precision, particularly when concerning early age atmenopause, making clinical application troublesome.

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UR - https://www.ncbi.nlm.nih.gov/pubmed/30032277

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