Anti‐Müllerian Hormone and Metabolic–Hormonal Profiles in Women With and Without Polycystic Ovary Syndrome: A Population‐Based Study

Abstract

ABSTRACT Introduction Evidence regarding age‐related variation in anti‐Müllerian hormone (AMH) and its associations with hormonal and metabolic parameters in women with polycystic ovary syndrome (PCOS), healthy women, and those with isolated PCOS features remains inconsistent. This study aimed to address these gaps using a cross‐sectional, population‐based approach. Methods A total of 883 women aged 18–45 years were categorized into three groups: PCOS (n = 124; Rotterdam criteria), suspicious (one PCOS criterion, n = 274), and healthy controls (n = 485). The coefficient of determination (R2) assessed age‐related AMH variation. Linear regression evaluated associations between AMH and hormonal and metabolic profiles. Age‐stratified multivariable logistic regression, adjusted for BMI, parity, and physical activity, examined associations between AMH and type 2 diabetes (T2DM), hypertension, metabolic syndrome (MetS), and dyslipidemia. Results Age explained nearly 40% of AMH variation in healthy women, but only 20% in those with PCOS. AMH was inversely correlated with BMI in healthy and suspicious groups, but not in PCOS. Among healthy women aged ≥ 35 years, higher AMH was associated with a 37% reduced likelihood of T2DM (OR: 0.63, 95% CI: 0.41–0.97). In contrast, among women with PCOS aged < 35 years, elevated AMH was associated with 2.6‐fold higher odds of MetS (OR: 2.6, 95% CI: 1.20–6.20). In the suspicious group, AMH correlated positively with free androgen index and prolactin. Conclusion AMH declines less with age in women with PCOS than in healthy women. Higher AMH may be protective against T2DM in older healthy women but indicates elevated metabolic risk in younger women with PCOS, suggesting that AMH may serve as a life‐course biomarker for metabolic risk stratification and personalized preventive strategies in women's healthcare.