Estrogen treatment improves arterial distensibility, fibrinolysis, and metabolic profile in postmenopausal women with type 2 diabetes mellitus

Sztejnsznajd, Claudia; Silva, Maria Elizabeth Rossi da; Nussbacher, Amit; Gebara, Otávio; D'Ámico, Elbio Antônio; Rocha, Dalva Marriero; Rocha, Tânia Rúbia Flores da; Santos, R. F.; Wajngarten, Maurı́cio; Fukui, Rosa Tsunechiro; Correia, M. R. S.; Wajchenberg, B. L.; Ursich, Mileni Josefina Maria

doi:10.1016/j.metabol.2006.03.003

Cited by 12 publications

(10 citation statements)

References 46 publications

(79 reference statements)

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“…A Japanese study reported that the menopause augments the age-related increase in arterial stiffness during the early postmenopausal phase and that this augmentation is probably related, at least in part, to estrogen deficiency [15]. Also, Sztejnsznajd and et al claimed that long-term administration of oral estrogens leads to an improvement in arterial distensibility in postmenopausal women [16]. The mean age of natural menopause in China was 48.7 years according to a recent study [17].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of arterial stiffness in North China, and associations with risk factors of cardiovascular disease: a community-based study

Wang

Zhou

2012

BMC Cardiovasc Disord

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BackgroundBrachial-ankle pulse wave velocity (baPWV), which reflects the stiffness of both central and peripheral muscular arteries, has been frequently used as a simple index for assessing arterial stiffness. The aim of the present study was to investigate the prevalence of arterial stiffness in North China based on baPWV measurements, and explore the associations between increased arterial stiffness and risk factors of cardiovascular diseases (CVD).MethodsTwenty-three community populations were established in North China. For each participant, parameters for calculating baPWV, including blood pressures and pressure waveforms, were measured using a non-invasive automatic device. All participants were required to respond to an interviewer-led questionnaire including medical histories and demographic data, and to receive blood tests on biochemical indictors.ResultsA total of 2,852 participants were finally investigated. Among them, 1,201 people with low burden of CVD risk factors were chosen to be the healthy reference sample. The cut-off point of high baPWV was defined as age-specific 90th percentile of the reference sample. Thus, the prevalence of high baPWV was found to be 22.3% and 26.4% in men and women respectively. After adjusted for age, heart rate (HR), systolic blood pressure (SBP), fasting glucose level, and smoking were significantly associated with high baPWV in men; while level of serum total cholesterol (TC), HR, SBP, and diabetes were significantly associated with high baPWV in women.ConclusionsBased on the age-specific cut-off points, the middle-aged population has a higher prevalence of high baPWV in North China. There exists a difference between men and women in terms of the potential risk factors associated with arterial stiffness.

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Section: Discussionmentioning

confidence: 99%

Prevalence of arterial stiffness in North China, and associations with risk factors of cardiovascular disease: a community-based study

Wang

Zhou

2012

BMC Cardiovasc Disord

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“…Many risk factors are likely to contribute to accelerated atherosclerosis in diabetes. These factors include dyslipidemia, hyperglycemia, hypertension and inflammation (Mazzone et al ., 2008; Pieske and Wachter, 2008); coagulation abnormalities, endothelial dysfunction (Sztejnsznajd et al ., 2006) and increased vascular oxidative stress (Shah et al ., 2007). In the nondiabetic population, women are relatively protected against coronary heart disease (CHD), compared with men, an effect attributed to the physiological effects of estrogens.…”

Section: Introductionmentioning

confidence: 99%

Glabridin, a phytoestrogen from licorice root, up‐regulates manganese superoxide dismutase, catalase and paraoxonase 2 under glucose stress

Yehuda

Madar

Szuchman-Sapir

et al. 2010

Phytotherapy Research

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The risk of death from cardiovascular diseases (CVDs), which are exacerbated by oxidative stress, is higher in diabetic women. This phenomenon has been attributed to the loss of estradiol-vascular protection. Such knowledge led us to examine the potential of glabridin, a phytoestrogen, to substitute estradiol up-regulation of antioxidant enzymes under high glucose conditions. Chronic glucose stress was found to down-regulate catalase (CAT) and paraoxonase 2 (PON2) mRNA expression by 20% and 17%, respectively, and to decrease PON2 activity by 83% in macrophages. Inflammatory conditions had an additive effect on PON2 expression in a time-dependent manner. Treatment with glabridin, under high glucose stress, increased PON2 activity by 60% and up-regulated its mRNA expression by 3.5 fold. Furthermore, glabridin up-regulated the expression of manganese superoxide dismutase (Mn-SOD) and CAT in monocytes. In conclusion, glabridin has the potential of strengthening the antioxidant defense mechanism and may serve as an antiatherogenic agent in diabetes.

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“…Neither showed detectible beneficial effects on any index of arterial properties or wave reflection characteristics. Other studies have also shown conflicting results e.g Stefanadis et al [184], Elsheikh et al [185] and Sztejnsznajd et al [186] showed beneficial hemodynamic effects while other studies did not [187,188]. The studies of Elsheikh et al and Sztejnsznajd et al used a newly available non-invasive method to obtain central aortic pressure and indices of arterial stiffness and wave reflections.…”

Section: Effects Of Hormone Treatment On Arte-rial Stiffness and Wavementioning

confidence: 99%

“…Several studies have measured arterial PWV in postmenopausal women receiving HT [65,[86][87][88][89][90][91][92][93]. Some of these studies measured elastic artery PWV e while others measured elastic and muscular artery PWV e+m ; the study by Waddell [87] measured muscular artery PWV m .…”

Section: Estrogenmentioning

confidence: 99%

Actions of Selected Cardiovascular Hormones on Arterial Stiffness and Wave Reflections

Nichols

Epstein²

2009

CPD

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The large conduit arteries of the thorax and abdomen are elastic while those in the arms and legs are muscular. Alterations in wall properties of elastic arteries occur over time and are usually permanent in nature; acute changes can, however, occur is response to a change in transmural pressure. Chronic alterations in properties of muscular arteries are minimal but changes (e.g vasoconstriction, vasodilation or tone) do occur in response to smooth muscle cell (SMC) stimulation. In general an increase in arterial stiffness (and wave reflection) increases systolic blood pressure (BP) and is detrimental while a decrease is beneficial. The augmentation in systolic BP increases left ventricular (LV) mass, wasted energy, tension-time index (TTI) and myocardial oxygen demand while the fall in diastolic BP decreases coronary artery perfusion causing a mismatch in ventricular/vascular coupling and an imbalance in the myocardial oxygen supply/demand ratio. Cardiovascular hormones such as renin, angiotensin, aldosterone, parathormone, sympathomimetic amines and endothelin induce vasoconstriction and increase arterial stiffness while insulin, thyroxine, testosterone, atrial natriuretic peptide (ANP), estrogen and nitric oxide (NO) have the opposite effect. The undesirable effects can be reversed with selected blocking agents. Vasodilator drugs have little direct active effect on large elastic arteries and unaugmented BP but can markedly reduce wave reflection amplitude and duration and augmentation index by decreasing stiffness of the muscular arteries and reducing transmission velocity of the reflected wave from the periphery to the heart. This decrease in amplitude and increase in travel time (or delay) of the reflected wave causes a generalized decrease in systolic BP, arterial wall stress, wasted LV energy and TTI.

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Estrogen treatment improves arterial distensibility, fibrinolysis, and metabolic profile in postmenopausal women with type 2 diabetes mellitus

Cited by 12 publications

References 46 publications

Prevalence of arterial stiffness in North China, and associations with risk factors of cardiovascular disease: a community-based study

Prevalence of arterial stiffness in North China, and associations with risk factors of cardiovascular disease: a community-based study

Glabridin, a phytoestrogen from licorice root, up‐regulates manganese superoxide dismutase, catalase and paraoxonase 2 under glucose stress

Actions of Selected Cardiovascular Hormones on Arterial Stiffness and Wave Reflections

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