Estriol (E3) Replacement Improves Endothelial Function and Bone Mineral Density in Very Elderly Women

Abstract

We investigated the effects of estriol (E3) on endothelial function and bone mineral density (BMD) in very elderly women. Twenty-four very elderly women (80 +/- 3.5 years old) were administered CaCl2 with or without estriol treatment (2 mg/day) for 30 weeks (hormone replacement treatment [HRT] group vs control group). Endothelium-dependent flow-mediated dilatation (FMD), endothelium-independent dilatation by nitroglycerin of the brachial artery, and BMD were assessed. Levels of plasma lipids and apoproteins were not changed; however, both plasma E3 and E2 were substantially increased (E2, 4.6 to 31.3 +/- 8.1; E3, <5 to 45.3 +/- 7.9 pg/mL) by HRT. The FMD value was also increased by HRT, as were the plasma nitrite/nitrate and cGMP values. The response to nitroglycerin was not changed. The BMD was increased by HRT, but decreased in the control group. There were significant differences between the HRT group and control group after 30 weeks' treatment in the levels of osteocalcin, P1CP, and urinary deoxypiridinoridine. E3 significantly improved BMD by inhibiting bone resorption. Endothelial function was improved in line with the antiatherosclerotic effects. E3 might be effective for use in HRT in elderly patients.

Effects of exercise on lipid metabolism and musculoskeletal fitness in female athletes

“…This study has shown that hormones and exercise interact to influence bone adaptations, and thus raise E 3 level related to increased BMD following exercise in female athletes. For example, serum E 2 , cortisol, PTH and T 3 levels in the athlete group were higher than those of the controls, and the major finding of this study was that increased radius BMD (K<0.05) and calcaneus BMD (K<0.01, P<0.05) were significantly and positively related to serum E 3 (K<0.01, P<0.01) concentrations [10][11][12] . Therefore, a clear understanding the interaction suggested by the present data between E 3 concentration and the adaptation of bone to exercise is important, and provides an interaction through which the estrogen receptors involved in the early response of bone cells might increase their responsiveness to loading [11,12] .…”

“…For example, serum E 2 , cortisol, PTH and T 3 levels in the athlete group were higher than those of the controls, and the major finding of this study was that increased radius BMD (K<0.05) and calcaneus BMD (K<0.01, P<0.05) were significantly and positively related to serum E 3 (K<0.01, P<0.01) concentrations [10][11][12] . Therefore, a clear understanding the interaction suggested by the present data between E 3 concentration and the adaptation of bone to exercise is important, and provides an interaction through which the estrogen receptors involved in the early response of bone cells might increase their responsiveness to loading [11,12] . These results indicate that physical exercise positively affects the maintenance of radius BMD (K<0.05), calcaneus BMD (K<0.01, P<0.05) in female athletes, thus increased E 3 level can prevent BMD loss and possible risk of osteoporosis [12] .…”

“…Consequently, lifelong physical exercise is recommended to optimize health-related benefits [2][3][4][5][6][7][8] . And the influence of physical activity and exercise training on BMD in females previously has been assessed in cross-sectional, retrospective longitudinal and controlled trial studies [3][4][5][6][7][8][9][10][11][12][13] . Even though no relationship about growth hormone and BMD was found.…”

“…Even though no relationship about growth hormone and BMD was found. But the effect of E 3 significantly improved BMD by inhibiting bone resorption, female athletes with low estradiol (E 2 ) level take a risk for increased lipid peroxidation following exercise [11][12][13][14][15] . Thus hormone status and lipid metabolism may play an important role in the protection against cardiovascular disease, this physiological response has implications for risks of heart disease.…”

“…Longitudinal information on associations between life style factors and age-related bone loss remains quite controversial. Some studies have found no relationship between bone loss and body composition or body weight, while others have shown them to predict bone mass changes [3][4][5][6][7][8][9][10][11][12][13][14][15][16] . Therefore, the purpose of this study was to explore the physiological function of female athletes, including BMD, renal function, liver function, hormone status, bone marker assay, lipid metabolism and muscle biology related to the effectiveness of exercise intervention for the health status of female athletes compared with controls.…”