Anti-Müllerian Hormone Levels and Urinary Cortisol in Women With Chronic Abdominal Pain.
Theresa M Hardy, Donna O McCarthy, Nicolaas H Fourie and 1 others
PMID 27639111WHAT IT FOUND
AMH levels were not associated with chronic abdominal pain, urine cortisol, serum cortisol, or body fat.
When AMH was classified as normal or abnormal, abnormal AMH was associated with chronic abdominal pain and lower urine cortisol, but this involved only 5 women.
Key findings
01Serum AMH levels, analyzed as continuous values, were not associated with chronic abdominal pain, urine cortisol, serum cortisol, or body fat, with or without age adjustment.
02Women with chronic abdominal pain had lower urine cortisol and lower LH levels than women without chronic abdominal pain.
03When AMH was classified as abnormal or normal, the 5 participants with abnormal AMH had chronic abdominal pain 100% of the time versus 38% of the 31 participants with normal AMH (p = 0.01), and abnormal AMH also corresponded with lower 5 hour urine cortisol values of 16 ± 11 versus 45 ± 49 (p = 0.04).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was a pilot with 36 women, and only 5 women had abnormal AMH, so the categorical AMH findings are unstable. The data were cross-sectional, so the study cannot show that chronic abdominal pain caused lower cortisol or abnormal AMH. The analysis was exploratory and did not adjust for multiple comparisons. Participants were selected from a subset of a natural history protocol and excluded many common conditions, so the findings may not apply to broader women with chronic abdominal pain. The positive AMH finding appeared only after AMH was categorized as normal or abnormal, while the continuous AMH analysis was null. The authors noted limited body fat range and small sample size as possible reasons body fat and oral contraceptive use did not show expected associations with AMH.
The easy way to misread this
Do not conclude that chronic abdominal pain causes abnormal AMH or diminished ovarian reserve. The main AMH analysis was not associated with chronic abdominal pain, and the positive finding came from a small categorical analysis of 5 women with abnormal AMH in a cross-sectional pilot.