Published: 2019-01-25

Serum anti-Mullerian hormone and homocysteine in premenopausal females with and without cardiovascular disease

Huma Khan, Madhur M. Gupta


Background: The objective of this study is to assess the association of anti-Mullerian hormone (AMH) and homocysteine (Hcy) levels in premenopausal females with and without cardiovascular disease.

Methods: A case control study was conducted in premenopausal, menopausal and normal fertile females (n=30) with and without cardiovascular disease in a tertiary care hospital and research centre in central India. Fasting sample obtained was assessed for AMH and Hcy levels. Results were compared and data was analyzed.

Results: The levels of AMH and Hcy were significantly altered in premenopausal and menopausal females as compared to normal fertile females. Moreover, there was a weak correlation when intergroup comparison was made between the parameters in females with and without cardiovascular disease.

Conclusions: A prospective study with a larger sample size to assess levels of AMH need to be performed to provide insight in premenopausal females for the early detection cardiovascular disease.


Anti-Mullerian hormone, Cardiovascular disease, Homocysteine, Pre-menopause

Full Text:



Kim ES, Menon V. Status of women in cardiovascular clinical trials. Arterioscler Thromb Vasc Biol. 2009;29:279-83.

Yang XP, Reckelhoff JF. Estrogen, hormonal replacement therapy and cardiovascular disease. Curr Opin Nephrol Hypertens. 2011;20(2): 133-8.

E Vet A, Laven JS, de Jong FH, Themmen AP, Fauser BC. Antimullerian hormone serum levels: a putative marker for overian aging. Fertil Steril. 2002;77:357-2.

Sirsikar M, Pinnelli V, Mohanty S, Jayashankar CA. Anti-Müllerian hormone in health and disease: a review. Int J Res Med Sci. 2016; 4(7):2514-20.

Atsma F, Bartelink ML, Grobbee DE, van der Schouw YT. Postmenopausal status and early menopause as independent risk factors for cardiovascular disease: a meta-analysis. Menopause. 2006;13(2):265-79.

Susan E, Haiying Chen, Thomas B Clarkson. Jay R Kaplan. Premenopausal antimüllerian hormone concentration is associated with subsequent atherosclerosis. Menopause. 2012;19(12): 1353-9.

Ganguly P, Alam SF. Role of homocysteine in the development of cardiovascular disease. Nutrit J. 2015;14(1):6.

Liao D, Tan H, Hui R, Li Z, Jiang X, Gaubatz J, et al. Hyperhomocysteinemia decreases circulating HDL by inhibiting apoA-I protein synthesis and enhancing HDL-C clearance. Circ Res. 2006;99:598-606.

Zhao Z, Wang H, Jessup JA, Lindsey SH, Chappell MC, Groban L. Role of estrogen in diastolic dysfunction. Am J Physiol Heart Circ Physiol. 2014;306: H628-40.

Crandall CJ, Barrett-Connor E. Endogenous sex steroid levels and cardiovascular disease in relation to the menopause: a systematic review. Endocrinol Metab Clin North Am. 2013;42:227-3.

Lowery JW, de Caestecker MP. BMP signaling in vascular development and disease. Cytokine Growth Factor Reviews. 2010;21(4):287-98.

Freeman EW, Sammel MD, Lin H, Gracia CR. Anti-Mullerian hormone as a predictor of time to menopause in late reproductive age women. J Clin Endocrinol Metab. 2012;97(5):1673-80.

Shaw CM, Stanczyk FZ, Egleston BL, Kahle LL, Spittle CS, Godwin AK, et al. Serum antimüllerian hormone in healthy premenopausal women. Fertil Steril. 2011;95(8):2718-21.

Zhang C, Yong C, Adachi MT, Oshiro S, Aso T, Kaufman RJ. Homocysteine induces programmed cell death in human vascular endothelial cells through the activation of the unfolded protein response. J Biol Chem. 2001;276:35867-4.

Gambacciani M, Mannella P. Homocysteine, menopause and cardiovascular disease. Menopause Int. 2007;13(1):23-6.

Hak AE, Polderman KH, Westendorp IC, Jakobs C, Hofman A, Witteman JC, et al. Increased plasma homocysteine after menopause. Atheroscler. 2000;149(1):163-8.

Wouters MG, Moorrees MT, van der Mooren MJ, Blom HJ, Boers GH, et al. Plasma homocysteine and menopausal status. Eur J Clin Invest. 1995;25(11):801-5.

De Kat AC, Verschuren WM, Eijkemans MJ, Broekmans FJ, Van Der Schouw YT. Anti-Müllerian hormone trajectories are associated with cardiovascular disease in women clinical perspective: results from the Doetinchem cohort study. Circulat. 2017;135(6):556-65.