Anti-Müllerian Hormone & Cardiovascular Risk in Males with Chronic Kidney Disease

Date
2024-10-02
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Abstract

Cardiovascular disease (CVD) is the leading cause of death globally and individuals living with chronic kidney disease (CKD) have an exceptionally high cardiovascular risk. Males living with CKD experience a disproportionately high risk of CVD mortality compared to females living with CKD. Reduced anti-Müllerian hormone (AMH), a hormone involved in sex differentiation and fertility, has been previously associated with CVD risk in healthy males and females, as well as in females living with CKD. However, whether AMH is linked to CVD in the high-risk population of males living with CKD is yet unknown. The aim of this exploratory cross-sectional study was to estimate the association between AMH and arterial stiffness, a validated predictor of CVD, in males living with CKD. Self-identified adult male individuals were recruited from Nephrology clinics in Calgary, Alberta, Canada. Individuals were included if they had a diagnosis of CKD (i.e. kidney damage or estimated glomerular filtration rate <60 ml/min/1.73 m2 for >3 months) and exclusion criteria included: 1) history of a major cardiovascular event, 2) history of any medical condition known to impact testicular function, and 3) current use of exogenous hormone therapy. Participant demographic information, medical history, physical examination, and laboratory data were collected alongside serum AMH levels, measured with a validated immunoassay. Using standardized protocols, pulse wave velocity (PWV) and aortic augmentation index (AIx) were measured to estimate arterial stiffness. Multivariable linear regression analyses assessed the relationship between AMH and each measure of arterial stiffness. Thirty-eight participants were recruited (29% early stage CKD, 42% advanced-stage CKD, 18% CKD treated with dialysis, 11% CKD treated with transplantation) with a median age of 44 years (IQR: 27). Age-adjusted models estimated the relationship between AMH and each measure of arterial stiffness to be statistically significant, though age was the primary driver of each relationship. Studies with larger sample sizes are needed to examine this further in addition to investigate other sex-specific cardiovascular risk factors for males living with CKD.

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Keywords
kidney, renal, hormone, chronic kidney disease, male reproductive health, cardiovascular health, cardiovascular, AMH, Anti-Müllerian Hormone
Citation
Larsen, N. (2024). Anti-Müllerian hormone & cardiovascular risk in males with chronic kidney disease (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.