Metabolic syndrome in postmenopausal women: the influence of oral or transdermal estradiol on inflammation and coagulation markers

• Published in: American journal of obstetrics and gynecology Vol. 199; no. 5; pp. 526.e1 - 526.e7
• Main Authors: Chu, Micheline C., MD, Cushman, Mary, MD, Solomon, Rachel, BA, Lobo, Rogerio A., MD
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.11.2008; Elsevier
• Subjects: Administration, Cutaneous; Administration, Oral; Adult; Antithrombins - analysis; Biological and medical sciences; Biomarkers - blood; Blood Coagulation; C-Reactive Protein - analysis; cardiovascular risk; Chemokine CCL2 - blood; E-Selectin - blood; Estradiol - administration & dosage; Estrogen Replacement Therapy - methods; Factor VII - analysis; Female; Fibrin Fibrinogen Degradation Products - analysis; Fibrinogen - analysis; Gynecology. Andrology. Obstetrics; Humans; Inflammation; Interleukin-6 - blood; Matrix Metalloproteinase 9 - blood; Medical sciences; Metabolic diseases; metabolic syndrome; Metabolic Syndrome - metabolism; Middle Aged; Miscellaneous; Obstetrics and Gynecology; oral estrogen; Other metabolic disorders; Plasminogen Activator Inhibitor 1 - blood; postmenopausal; Postmenopause; Tissue Inhibitor of Metalloproteinase-1 - blood; transdermal estrogen; metabolic syndrome; oral estrogen; cardiovascular risk; transdermal estrogen; postmenopausal; Endocrinopathy; Human; Blood coagulation; Gynecology; Estrogen; Oral administration; Metabolic diseases; Cardiovascular disease; Inflammation; Marker; Metabolic syndrome; Estradiol; Obstetrics; Postmenopause; Female; Woman
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2008.04.033

Objective The objective of the study was to determine whether the route of administration of estrogen therapy in women with metabolic syndrome (MBS) influences inflammation and coagulation parameters. Study Design Fifty symptomatic postmenopausal women with MBS were randomized to receive 1 mg oral estradiol (oE2 ) or 0.05 mg transdermal E2 (tE2 ) for 3 months. Measurements were compared with those of 20 healthy premenopausal women and 74 normal postmenopausal women. Results Compared with both control groups, women with MBS had significantly higher levels of certain inflammation and coagulation markers, which cannot be accounted for based on weight alone. After oE2 , antithrombin III decreased from 104% to 96% ( P < .01), the metalloproteinase-9/ tissue inhibitor of metalloproteinase-1 ratio increased ( P < .02), and E-selectin decreased from 60 ± 4.4 to 55 ± 4.6 ng/mL ( P < .05). With tE2 , there were no major changes noted. Conclusion Postmenopausal women with MBS have higher levels of certain coagulation and inflammation markers and different responses to oral compared with transdermal estradiol.