Low-dose estradiol and endothelial and inflammatory biomarkers in menopausal overweight/obese women

• Published in: Climacteric : the journal of the International Menopause Society Vol. 19; no. 4; pp. 337 - 343
• Main Authors: da Silva, L. H. A., Panazzolo, D. G., Marques, M. Ferreira, Souza, M. G. C., Paredes, B. Dias, Nogueira Neto, J. F., Leão, L. M. C. S. M., Morandi, V., Bouskela, E., Kraemer-Aguiar, L. G.
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 03.07.2016; Taylor & Francis Ltd
• Subjects: atherosclerosis; Biomarkers; Biomarkers - blood; Body Mass Index; Double-Blind Method; Endothelial Progenitor Cells - drug effects; estradiol; Estradiol - administration & dosage; estrogen replacement therapy; Estrogen Replacement Therapy - methods; Estrogens; Estrogens - administration & dosage; Female; Humans; Inflammation Mediators - blood; Laser-Doppler Flowmetry; Menopause; Microvessels - drug effects; Middle Aged; Obesity; Obesity - blood; Obesity - physiopathology; Overweight - blood; Overweight - physiopathology; Postmenopause - drug effects; Vasodilation - drug effects; Vasomotor System - drug effects; Womens health; atherosclerosis; Obesity; menopause; estrogen replacement therapy; estradiol
• ISSN: 1369-7137; 1473-0804
• DOI: 10.1080/13697137.2016.1180676

Objective: We aimed to investigate the effects of low-dose transdermal estrogen on endothelial and inflammatory biomarkers in menopausal overweight/obese women. Methods: We recruited 44 menopausal women (47-55 years; body mass index 27.5-34.9 kg/m 2 ) and divided them into estradiol (1 mg/day; n = 22) or placebo groups (n = 22). They were double-blinded, followed and treated for 3 months. At baseline and post-intervention, inflammatory biomarkers (hs-CRP, IL-1β, IL-6, MCP-1 and TNF-α) and of vascular injury (activated circulating endothelial cells, CEC-a) and repair (endothelial progenitor cells, EPC) were quantified. Resting CECs (CEC-r) were also assessed. Microvascular reactivity and vasomotion were analyzed by laser-Doppler flowmetry. Results: Volunteers (51.8 ± 2.3 years; mean body mass index 31.5 ± 2.5 kg/m 2 ) had been menopausal for 3 (range 2-5) years. After treatment, no changes were observed in the placebo group, while levels of CEC-r and EPC increased in the estradiol group. In this group, no changes in inflammatory biomarkers were observed but it required a lower cumulative dose of acetylcholine to achieve peak velocity during endothelial-dependent vasodilatation and there was increased endothelial-independent vasodilatation. Conclusions: The short-term use of low-dose transdermal estradiol therapy in overweight/obese menopausal women increased markers of vascular repair and improved microvascular reactivity without changing the inflammatory biomarkers. Clinical trial registration: NCT01295892 at www.clinicaltrials.gov .