Page 114 - Fertility in Women with Rheumatoid Arthritis Vruchtbaarheid van vrouwen met reumatoïde artritis

Chapter 7
the full model shown in table 4 with a simple model of AMH based on age alone using a likelihood ratio test, did not reveal any signi cant differences, con rming the ndings in table 4.
Table 4 - estimates of linear mixed model describing the change of serum anti-Müllerian hormone (AMH) levels (applying square root transformation) with increasing age in 128 female RA patients
Variable
(Intercept)
Biological age - per year $ Disease duration ƚ Presence of ACPA ƚ Presence of Erosions ƚ Presence of RF ƚ
Ever used MTX
Age * Disease duration ACPA * Erosions
ACPA * RF
Erosions * RF
ACPA* Erosions * RF
Estimate Standard error
4.648 0.350 -0.077 0.007 0.015 0.031 -0.544 0.349 -0.076 0.239 -0.312 0.281 0.005 0.187 -0.001 0.001 0.364 0.447 0.413 0.441 -0.146 0.390 -0.121 0.573
95% Con dence interval
ACPA = anti-citrullinated protein antibodies ; RF = rheumatoid factor ; MTX = methotrexate $ age is used as time variable in the model
ƚ variable at baseline
ǂ p<0.05
The additional analysis with gynaecological age as time variable, was performed in the 122 patients that reported their age at menarche. Besides the decline of AMH with increasing gynaecological age, no other variables did show a signi cant effect. The full model based on gynaecological age was not signi cantly different from a simple model of AMH based on gynaecological age exclusively.
DISCUSSION
Women with RA had a compromised ovarian function compared to healthy controls, with a considerably larger proportion of women with RA having AMH levels below the age-speci c 10th percentile. Assessment of serum AMH levels over time in female RA patients revealed that levels decreased more rapidly in patients compared to controls. Longitudinal analyses did not show any signi cant effect of RA-related factors on serum AMH levels.
112
3.962 - -0.090 - -0.046 - -1.227 - -0.545 - -0.863 - -0.361 - -0.002 - -0.512 - -0.451 - -0.910 - -1.243 -
5.334
-0.063 ǂ 0.076
0.140
0.393
0.239
0.372
0.001
1.239
1.276
0.618
1.001