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Author Notes:

Correspondence to Ms Meghan Angley; mangley@emory.edu

PPH and SSL designed the study.

MA and PPH conceived the analysis.

MA executed the analysis and drafted the manuscript.

All authors revised the manuscript for important content and approved the final version.

The authors would like to thank all the patients for their participation in this study.

Competing interests: None declared.


Research Funding:

This research was supported by grant funding from the National Institutes of Health (1R01HD066059) and a Synergy Award from the Woodruff Health Sciences Center at Emory University.

MA is supported by a National Institutes of Health grant (T32HL130025).

The GOAL Cohort is funded by and SSL is supported by the Centers for Disease Control and Prevention (CDC-U01DP005119 and CDC-U01DP006488).


  • Science & Technology
  • Life Sciences & Biomedicine
  • Rheumatology
  • lupus erythematosus
  • systemic
  • cyclophosphamide
  • inflammation
  • AGE

Anti-Mullerian hormone in African-American women with systemic lupus erythematosus


Journal Title:



Volume 7, Number 1


Type of Work:

Article | Final Publisher PDF


Objective: Women with SLE may experience ovarian insufficiency or dysfunction due to treatment or disease effects. Anti-Müllerian hormone (AMH), a marker of ovarian reserve, has been examined in small populations of women with SLE with conflicting results. To date, these studies have included very few African-American women, the racial/ethnic group at greatest risk of SLE. Methods: We enrolled African-American women aged 22-40 years diagnosed with SLE after age 17 from the Atlanta Metropolitan area. Women without SLE from the same area were recruited from a marketing list for comparison. AMH was measured in serum using the Ansh Labs assay (Webster, Texas, USA). We considered AMH levels <1.0 ng/mL and AMH <25th percentile of comparison women as separate dichotomous outcomes. Log-binomial regression models estimating prevalence ratios were adjusted for age, body mass index and hormonal contraception use in the previous year. Results: Our sample included 83 comparison women without SLE, 68 women with SLE and no history of cyclophosphamide (SLE/CYC-) and 11 women with SLE and a history of cyclophosphamide treatment (SLE/CYC+). SLE/CYC+ women had a greater prevalence of AMH <1.0 ng/mL compared with women without SLE (prevalence ratio (PR): 2.90, 95% CI: 1.29 to 6.51). SLE/CYC- women were also slightly more likely to have AMH <1.0 ng/mL (PR: 1.62, 95% CI: 0.93 to 2.82) than comparison women. Results were similar when considering AMH <25th percentile by age of comparison women. Conclusions: Treatment with CYC is associated with low AMH in African-American women with SLE. SLE itself may also be associated with reduced AMH, but to a lesser extent.

Copyright information:

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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