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PubMed2006

The effect of hormone replacement therapy on the levels of serum lipids, apolipoprotein AI, apolipoprotein B and lipoprotein (a) in Turkish postmenopausal women.

OBJECTIVES: Estrogen replacement therapy alters the lipid profiles favorably for delaying atherosclerosis in postmenopausal women. The effects of estrogen plus progesterone combination therapy on lipids are controversial. This study was designed to evaluate the effect of female sex hormones on lipids and lipoproteins and to clarify the influence of progesterone on the effect of estrogen in postmenopausal women. METHODS: Of the 60 postmenopausal women admitted to our menopause clinic, 40 had intact uterus and received continuous 0.625 mg conjugated equine estrogen (CEE) plus 2.5 mg medroxyprogesterone acetate (MPA), whereas the remaining 20 were hysterectomized and received 0.625 mg CEE daily. To assess the alterations in lipids and lipoproteins during menopause, 45 healthy premenopausal women were investigated. Lipid and lipoprotein levels were assessed in each subject at baseline and at the 6th and 18th months of therapy. RESULTS: In menopause, a shift towards more atherogenic lipid and lipoprotein profiles than those of the premenopausal state was found. Following 18 months of treatment, both regimens reduced total cholesterol (TC) levels as compared with the baseline (6.4 vs. 6.9% in the CEE/MPA and CEE groups, respectively). The CEE group had a more pronounced increase in high-density lipoprotein (HDL) cholesterol than the CEE/MPA group (10.3 vs. 8.8%, respectively). Both groups displayed reduced TC, low-density lipoprotein (LDL) cholesterol and apolipoprotein-B (ApoB) concentrations, whereas triglycerides increased, with a greater tendency to increase in the CEE/MPA group at the end of the trial. Also, the lipoprotein (a) [Lp(a)] levels decreased significantly (27.6 vs. 24.5% in the CEE/MPA and CEE groups, respectively). This decrease was more pronounced in subjects with a relatively higher basal Lp(a) concentration. CONCLUSION: Both treatment regimens caused positive alterations in the lipid and lipoprotein profiles. This association might play a pivotal role in the postmenopausal increases in atherosclerotic diseases and cardioprotective effect of estrogen in postmenopausal women.

Adult↗

PubMed2006

Body fat and blood lipids in postmenopausal women are related to resting autonomic nervous system activity.

The present study investigated the activity of the autonomic nervous system (ANS), a major influence in normal physiological function, and its association with unfavorable postmenopausal states in body composition, lipid and/or glucose metabolism, or cardiovascular profiles. Body composition, blood pressure, and blood profiles of lipid and glucose of 175 postmenopausal women were measured. Resting ANS activity was assessed by heart rate variability (HRV) power spectral analysis. To scrutinize the influence of ANS activity levels on postmenopausal obesity-related factors, we divided the subjects into a low group ( < 220 ms(2)) and a high group ( > 220 ms(2)), based on the total power of HRV. Low-frequency (P < 0.01) and high-frequency power (P < 0.01) were both significantly lower in the low group. No significant difference was found in age, age at menopause, or years after menopause between the two groups. In contrast, body mass index (P < 0.05), percentages of body fat (P < 0.01), and systolic (P < 0.01) and diastolic (P < 0.01) blood pressure were significantly greater in the low group. As to blood lipid profiles, triglycerides (P < 0.05), total cholesterol (P < 0.05), and low-density lipoprotein cholesterol (P < 0.05) were significantly higher in the low group. Our findings indicate that reduced sympatho-vagal activity is associated with higher postmenopausal body fat content, blood pressure, and blood lipid concentrations. This study further implies that such autonomic depression could be a crucial risk factor in undermining the health and, ultimately, the quality of life, of postmenopausal women.

Autonomic Nervous System↗

PubMed2003

Predicting bone mineral density of postmenopausal healthy and cirrhotic Italian women using age and body mass index.

The objective of the present report was to develop mathematical prediction formulae for the lumbar spine, pelvis and total bone mineral density (BMD) based on the osteoporosis risk factors age and BMI in healthy and cirrhotic postmenopausal women. The study population comprised 20 postmenopausal cirrhotic women (late PM cirrhotic women), 20 postmenopausal healthy women matched for age and BMI (late PM healthy women), and 19 younger postmenopausal healthy women matched for BMI (early PM healthy women). Segmental and total bone mineral content and BMD, total bone-free lean body mass and total fat mass were measured for all women using dual X-ray absorptiometry (DXA). The prediction formulae for late PM cirrhotic women had higher cumulative correlation coefficients ( r=0.71, p=0.05 for spine BMD, r=0.84, p=0.013 for pelvis BMD, and r=0.89, p=0.004 for total BMD) than those for early PM healthy women ( r=0.64, p=0.015 for spine BMD, r=0.69, p=0.002 for pelvis BMD, and r=0.62, p=0.022 for total BMD) and late PM healthy women ( r=0.29, p=NS for spine BMD, r=0.39, p=NS for pelvis BMD, and r=0.54, p=NS for total BMD). The mathematical formulae based on the variables age and BMI were capable of predicting lumbar spine BMD, pelvis BMD, and total BMD by DXA for the three groups of postmenopausal women.

Aged↗

PubMed2003

Cholesterol-fed ovariectomized monkeys are good animal models for human atherosclerosis of postmenopausal women.

Although it is well known that the incidence of atherosclerosis is markedly increased in postmenopausal women, antiatherosclerotic effects of estrogen replacement therapies are not clear. One of the reasons for this is due to the lack of appropriate animal models for atherosclerosis of postmenopausal women. Therefore, we attempted to develop an animal model for atherosclerosis of postmenopausal women and examined the antiatherosclerotic effects of estrogen replacement therapy. Adult ovariectomized Japanese monkeys were fed 2% cholesterol diet alone (C-group) or in combination with conjugated estrogen (CE-group) for 30 months. The serum estradiol-17beta levels of the CE-group were varied between 10 and 204.5 ng/dl during treatment. In the C-group, the serum total cholesterol levels were increased from 110 to 270 mg/dl, and atheroma was first observed after 3-months treatment with angioscopy. In the CE-group, the levels of the serum total cholesterol during treatment were 30% lower than those of the C-group, and the aortic lesions were first observed after 12-months treatment with angioscopy. The aortic intimal thickness of the CE-group was 58% of the C-group. This finding showed good agreement with the angioscopic observation. The aortic lesions were of a fibromuscular type in both groups. In conclusion, a cholesterol-fed ovariectomized monkey is an appropriate animal model for atherosclerosis of postmenopausal women. Furthermore, angiofiberscopic and histopathological observations suggested that estrogen replacement therapy was valid for atherosclerosis of postmenopausal women.

Animals↗

PubMed2004

Differential association of modifiable health behaviors with hot flashes in perimenopausal and postmenopausal women.

OBJECTIVE: To determine the association of modifiable factors, such as smoking, body mass index, and alcohol use, with hot flashes, and to ascertain whether the association with hot flashes varies by menopausal stage. DESIGN: A written survey completed by perimenopausal and postmenopausal women enrolling in a randomized, controlled trial of a menopause risk management program in 1999. Survey items included questions on demographics, health status, and health behaviors. SETTING: A Massachusetts-based health maintenance organization. PATIENTS/PARTICIPANTS: Female members, age 40 to 65, excluding women with chronic conditions precluding study participation, were randomly selected from an automated medical record system. MEASUREMENTS AND MAIN RESULTS: The majority of the 287 postmenopausal and 468 perimenopausal women participating in the study were white, college educated, and nonsmoking. Approximately 30% of both groups reported experiencing hot flashes. Separate multivariable logistic regression models were developed for perimenopausal and postmenopausal women to identify correlates of reporting any versus no hot flashes. After controlling for age, race, oral contraceptive use, hormone replacement therapy use, and depression, correlates of hot flashes in perimenopausal women were body mass index >/=25 kg/m(2) (odds ration [OR], 2.00; 95% confidence interval [CI], 1.28 to 3.12) and alcohol use of 1 to 5 drinks per week (OR, 0.52; 95% CI, 0.31 to 0.86). The only significant correlate of hot flashes in the postmenopausal population was high dietary fat intake (OR, 0.35; 95% CI, 0.15 to 0.81). CONCLUSION: Although study respondents were from similiar sociodemographic groups and received their health care in the same health maintenance organization, modifiable factors associated with hot flashes were different for perimenopausal and postmenopausal women.

Adult↗

PubMed2002

Relationships between intestinal calcium absorption, serum vitamin D metabolites and smoking in postmenopausal women.

Smoking has been associated with low bone density, fractures and poor intestinal calcium absorption. Calcium absorption is a critical factor in calcium balance in postmenopausal women but the mechanisms causing decreased absorption efficiency in postmenopausal smokers are controversial and poorly defined. We performed a cross-sectional study of 405 postmenopausal women attending a clinic for the management of osteoporosis to compare intestinal calcium absorption efficiency, serum vitamin D metabolites and parathyroid hormone levels in postmenopausal women who had never smoked, who were smokers previously or who were current smokers, to examine the relationships between these variables in smokers. Two hundred and fifty-two of the women had never smoked, 79 had smoked previously and 74 were current smokers. The hourly fractional rate of calcium absorption was similar in non-smokers and those who had previously smoked. Radiocalcium absorption was less in the 74 smokers compared with the 331 non-smokers [0.60 (0.29 SD) vs 0.71 (0.27); p = 0.004], as were serum calcitriol (p<0.001) and parathyroid hormone (PTH) (p<0.01). There was no difference in the relationship between calcium absorption and serum calcitriol between smokers (r = 0.38) and non-smokers (r = 0.28); hence the impaired calcium absorption in the smokers was almost entirely attributable to suppression of the PTH-calcitriol endocrine axis. In postmenopausal women smoking is associated with a reduction in calcium absorption efficiency due to suppression of the PTH-calcitriol axis. This impairment of calcium absorption could lead to accelerated bone loss and limit the usefulness of dietary calcium supplementation.

Aged↗

PubMed2002

The role of trace minerals in the pathogenesis of postmenopausal osteoporosis and a new effect of calcitonin.

The physiologic role of calcitonin in mineral and bone homeostasis is not very well understood. Very few longitudinal studies have reported the effects of calcitonin therapy on trace minerals in postmenopausal osteoporosis despite the documented involvement of trace minerals in normal skeletal metabolism. Several trace minerals, particularly magnesium (Mg) and zinc (Zn), essential for organic bone matrix synthesis have been known for at least three decades. The present study was designed to determine whether the mineral profile was different between 70 osteoporotic and 30 nonosteoporotic postmenopausal women and to evaluate the efficacy of calcitonin therapy for 6 months on these trace minerals in postmenopausal osteoporotic women. In our study, the serum values of Mg, copper (Cu), and Zn (P < 0.05) were significantly lower in the patient group than those in the control group. After 3 months of treatment, serum Cu, Zn, and Mg levels did not differ between the patients and controls, and this situation has continued after the end of 6 months of therapy. Serum Cu, Zn, and Mg levels increased consistently during the 6-month treatment period. The higher levels of serum Mg in the 3rd and 6th months of therapy were found to be statistically significant compared to those before treatment (P < 0.05). Serum Cu and Zn levels were found to be significantly higher at all measurements during the treatment period as well as at the end of therapy (P < 0.05). These results suggest that (1) calcitonin therapy regulates Mg, Cu, and Zn levels in postmenopausal osteoporosis; (2) when serum calcium and phosphorus were normal in postmenopausal osteoporosis, serum Mg, Cu, and Zn were more useful for evaluation; and (3) further studies are essential to evaluate the role of dietary composition on the manifestations of osteoporosis.

Aged↗

PubMed1993

Thrombosis and hormone replacement therapy in postmenopausal women.

OBJECTIVE: The effects of postmenopausal hormone replacement therapy on thrombosis remain controversial. We tested the hypothesis that estrogen or progesterone has no significant effect on thrombosis by means of newly developed markers of blood clotting, specifically prothrombin fragment 1 + 2, a marker of factor Xa generation, and thrombin-antithrombin III complex, a marker of thrombin generation. STUDY DESIGN: A prospective study that included 106 women, 68 postmenopausal women on hormone replacement therapy and 38 postmenopausal controls, was performed. Plasma levels of prothrombin fragment 1 + 2 and thrombin-antithrombin III complex were measured by enzyme-linked immunosorbent assay. Multivariate analysis of the covariance was used for statistical analysis, controlling for patient's age because the hormone replacement therapy group was older. RESULTS: There were no statistically significant differences between the hormone replacement therapy and control groups in either of the clotting parameters measured. A comparison of the levels of prothrombin fragment 1 + 2 and thrombin-antithrombin III complex in patients receiving estrogen alone or estrogen plus progestin also revealed no differences. CONCLUSIONS: Current doses of postmenopausal hormone replacement therapy do not appear to enhance in vivo clotting. Thromboembolic complications among postmenopausal women receiving hormone replacement therapy may therefore be secondary to congenital or other acquired coagulation defects.

Adult↗

PubMed1993

Hormone production by the postmenopausal ovary in cases of benign ovarian neoplasia.

OBJECTIVE: The objective of this study was to determine whether hormone production by postmenopausal ovaries containing benign ovarian tumors differed from that of normal postmenopausal ovaries. STUDY DESIGN: The sera of 32 postmenopausal patients were assayed before and after bilateral oophorectomy for estrone, 17 beta-estradiol, androstenedione, testosterone, and dehydroepiandrosterone sulfate. The data from all patients as a group were analyzed, followed by analysis of the data from 15 patients with normal ovaries separately from the remaining 17 patients who had nonfunctioning, benign ovarian tumors. RESULTS: For patients with benign ovarian tumors there was a statistically significant drop in estrone (from a presurgical level of 55.8 +/- 46.3 pg/ml to a postoperative level of 29.9 +/- 10.2 pg/ml, p < 0.03) and 17 beta-estradiol (from 18.6 +/- 14.1 pg/ml preoperatively to 9.8 +/- 3.8 pg/ml postoperatively, p < 0.02). For postmenopausal woman with normal ovaries there was no significant drop in estrone or 17 beta-estradiol after bilateral oophorectomy. There was a statistically significant drop in testosterone and androstenedione after bilateral oophorectomy both for women with normal ovaries and for those with benign tumors. No significant differences in dehydroepiandrosterone sulfate were noted in either group. CONCLUSIONS: These data suggest that, although normal postmenopausal ovaries have not been demonstrated to secrete clinically significant amounts of estrogen, those that contain benign ovarian tumors do secrete small but significant amounts of estrone and 17 beta-estradiol. Both tumor-containing and normal ovaries secrete the androgens androstenedione and testosterone, this secretion not being significantly influenced by the presence of a tumor.

Female↗

PubMed1996

Reduced mortality associated with long-term postmenopausal estrogen therapy.

OBJECTIVE: To compare all-cause and specific-cause mortality rates in women who had or had not used long-term postmenopausal estrogen replacement therapy (ERT). METHODS: We identified women who used long-term postmenopausal ERT and compared them with a sample of age-matched postmenopausal nonusers. Through linking of these subjects' medical record numbers to various data bases, we examined survivorship and cause of death among estrogen users and nonusers. The risk of death in 232 postmenopausal women who began ERT within 3 years of menopause and used it for at least 5 years was compared with that of 222 age-matched postmenopausal nonusers. In the users, the mean length of estrogen use was 17.1 years. RESULTS: Statistically significant reductions in all-cause mortality were found in users compared with nonusers. For death from any cause, the age-adjusted relative risk (RR) and associated 95% confidence interval (CI) in estrogen users was 0.54 (0.38-0.76). The reduction in all-cause mortality was largely due to reductions in coronary heart disease (RR 0.40, CI 0.16-1.02) and other cardiovascular disease (RR 0.27, CI 0.10-0.71). Overall cancer mortality was similar in the two groups (RR 0.85, CI 0.46-1.58), although estrogen users had a higher risk of death from breast cancer (RR 1.89, CI 0.43-8.36) and lower risk of death from lung cancer (RR 0.22, CI 0.04-1.15). CONCLUSION: Long-term ERT use is associated with lower all-cause mortality and confers this apparent protection primarily through reduction in cardiovascular disease.

Cause of Death↗

PubMed1996

Postmenopausal hormone therapy and breast cancer.

Given the magnitude of the older female population, the possibility that postmenopausal hormone therapy is associated with an increased risk of breast cancer is an issue of great public and individual importance. Epidemiologic evidence indicates the possibility of a slightly increased risk of breast cancer associated with long durations of postmenopausal estrogen use. However, in a review of the literature, it is apparent that the epidemiologic data are contradictory and do not yield uniform and consistent results. It is further apparent that adding a progestin to a postmenopausal hormone program does not alter the findings compared with the use of estrogen alone. Reasons for this disagreement and lack of definitive evidence are detailed, and it is suggested that any impact of postmenopausal hormone therapy on the risk of breast cancer is unlikely to be great. Finally, the question of whether a woman who has had breast cancer should use postmenopausal hormones is addressed.

Administration, Intravaginal↗

PubMed1993

Effects and acceptability of a new 17 beta-oestradiol-releasing vaginal ring in the treatment of postmenopausal complaints.

The treatment of postmenopausal symptoms was studied in 26 healthy women using a new synthetic rubber (Kraton D 2109) vaginal ring containing 53 mg of 17 beta-oestradiol. All women were postmenopausal, at least 6 months after the last vaginal bleeding and suffering from daily hot flushes. The study was conducted in a double-blind placebo-controlled intrapatient cross-over fashion, and the study period was 6 months. The rings used give an initial in vitro release rate of 0.4 mg/E2 per day. The in vitro release rate decreases to about 0.2 mg/day after 20 days and levels off asymptotically to about 0.1 mg/day after 50 days. Serum E2 levels equivalent to the follicular phase of the normal menstrual cycle were measured after 1 month's use, and serum E2 level stayed above postmenopausal levels throughout the study period. FSH was suppressed during use of the E2-releasing vaginal ring, while LH showed no statistically significant suppression in continued use. Postmenopausal complaints were recorded by Visual Analogue Scales (VAS) as judged by both the patient and the examining doctor; all complaints had favourable outcomes during use of the E2-releasing vaginal ring without deterioration of symptoms during use of the placebo ring. No serious side-effects were encountered, and the possibility of managing all postmenopausal complaints with intravaginal oestrogen treatment is discussed.

Administration, Intravaginal↗

PubMed1991

Serum-free gamma carboxyglutamic acid (free Gla) is a poor biochemical marker of bone resorption in early postmenopausal women.

In this study, we assessed the potential value of serum-free Gla to reflect changes of bone turnover at menopause. Serum-free Gla was measured in 49 healthy postmenopausal women and 19 healthy age-matched premenopausal women. No difference in serum-free Gla concentrations was observed between the two groups. In a double-blind longitudinal study of 36 postmenopausal women (a subgroup of the above 49 women) treated with either oral oestradiol valerate in a cyclical combination with cyproterone acetate (n = 19) or placebo (n = 17) for nine months, the serum-free Gla concentration was unchanged with placebo and decreased by only 10% after hormonal replacement therapy. Initial serum-free Gla concentrations in postmenopausal women did not correlate with other biochemical markers of bone turnover. The predictive value of serum-free Gla concentration for the spontaneous rate of bone loss in early postmenopause was also assessed, and the marker showed no correlation to bone loss. These data indicate that the serum concentration of free Gla is not a useful marker of the bone turnover rate in the early postmenopause.

Biomarkers↗

PubMed1995

Calcium supplementation and bone mineral density in postmenopausal women using estrogen replacement therapy.

Both estrogen and calcium have been shown to be of benefit in reducing the incidence of osteoporosis in postmenopausal women. It has been suggested that estrogen promotes the intestinal absorption of calcium, and this effect may especially benefit postmenopausal women with a low dietary intake of calcium. The purpose of this study was to examine the effect of calcium supplementation on the bone mineral density (BMD) of postmenopausal women using estrogen replacement therapy. BMD measurements were made over 12 months in two groups of postmenopausal women, one having treatment with estrogen alone, and the second having estrogen and 1000 mg of supplemental calcium each day. There was no significant reduction in BMD between the two groups over the 12-month study period. Those in the group having supplemental calcium had a significant increase in BMD at the femoral neck (p = 0.023), but not in other areas of the femur nor in the lumbar spine. The results of this study suggest that the addition of supplemental calcium may improve the bone mass of postmenopausal women using estrogen who have a low dietary calcium intake. This benefit appears to be more pronounced in corticocancellous than in trabecular bone, and may therefore have a greater effect on the femoral neck than the lumbar spine.

Absorptiometry, Photon↗

PubMed2006

Impairment of physical exercise capacity in healthy postmenopausal women.

BACKGROUND: Healthy postmenopausal women reveal a series of peripheral vascular abnormalities, whose possible consequences on exercise performance has not been yet elucidated. METHODS: We studied the response to strenuous exercise in 25 postmenopausal women (mean age 50 +/- 3 years) without cardiovascular risk factors or disease through an integrative cardiopulmonary test. RESULTS: In comparison with 25 premenopausal subjects matched for age and biophysical characteristics, postmenopausal women showed a lower maximal workload (P < .01) and maximum VO2 (P < .01), an early anaerobic threshold (P < .05), and a lower ratio between increase of VO2 consumption and work rate (P < .01). CONCLUSIONS: Our results suggest that menopause could represent an important concomitant cause in determining an impairment of exercise capacity. The set of cardiopulmonary abnormalities found in the present study seems to identify the peripheral circulation as the limiting system in postmenopausal women experiencing exercise intolerance. Finally, present findings are in favor of an early introduction of postmenopausal hormone replacement therapy.

Anaerobic Threshold↗

PubMed2004

Forearm endothelial function and bone mineral loss in postmenopausal women.

It is widely believed that the vasculature plays an important role in bone remodeling. We investigated the relationship between forearm endothelial function and bone mass in the lumbar spine in early postmenopausal women without a history of smoking or diabetes mellitus. We studied the forearm resistance artery endothelial function in 110 Japanese women-52 postmenopausal women with normal spinal bone mineral density (BMD), 36 postmenopausal women with osteopenia, and 22 osteoporotic postmenopausal women. Forearm blood flow (FBF) during reactive hyperemia and after sublingual nitroglycerin (NTG) administration was measured by strain-gauge plethysmography. BMD of the lumbar spine (L2-L4) was measured by dual-energy X-ray absorptiometry. After adjustment for age, body mass index, years since the start of menopause, and basal FBF, women with osteoporosis had a lower maximal FBF response to reactive hyperemia (28.4 +/- 3.8 mL/min per 100 mL tissue) than those with normal BMD (39.8 +/- 2.8 mL/min per 100mL tissue) or osteopenia (35.6 +/- 2.5 mL/min per 100mL tissue) (P = 0.029). A significant increase in serum angiotensin-converting enzyme (ACE) activity (P = 0.042) and a significant decrease in the serum concentrations of nitrite/nitrate (P = 0.041) were noted in osteoporotic women compared to women with normal BMD or osteopenia. The present findings suggest that postmenopausal women with low BMD, especially those with osteoporosis, have impaired endothelial function in the forearm resistance arteries.

Absorptiometry, Photon↗

PubMed2005

The effect of chronic consumption of red wine on cardiovascular disease risk factors in postmenopausal women.

BACKGROUND: Moderate red wine has been shown to reduce cardiovascular disease (CVD) risk, however the effects on certain CVD risk factors are unclear. In this study we have investigated the effects of dealcoholised red wine (DRW) and full-complement red wine (RW) on several cardiovascular risk factors in mildly hypercholesterolaemic postmenopausal women. OBJECTIVES: To elucidate whether the chronic consumption of red wine polyphenols improves risk factors associated with CVD in hypercholesterolaemic postmenopausal women. DESIGN: Forty-five hypercholesterolaemic postmenopausal women were randomly assigned to consume 400 mL/day of either water, DRW or RW for 6 weeks following a 4-week washout. Fasting measures of lipids, lipoproteins, insulin and glucose were taken at 0 and 6 weeks. RESULTS: DRW consumption had no effect of fasting concentrations of lipids, lipoproteins, insulin and glucose. However, chronic consumption of RW significantly reduced fasting LDL cholesterol concentrations by 8% and increased HDL cholesterol concentrations by 17% in hypercholesterolaemic postmenopausal women. CONCLUSIONS: Collectively, regular consumption of full-complement red wine reduces CVD risk by improving fasting lipid levels in hypercholesterolaemic postmenopausal women. This study uniquely demonstrated the LDL cholesterol-lowering effects of red wine in individuals at high CVD risk, which has not previously been shown.

Aged↗

PubMed2005

Bridging advanced glycation end product, receptor for advanced glycation end product and nitric oxide with hormonal replacement/estrogen therapy in healthy versus diabetic postmenopausal women: a perspective.

Cardiovascular diseases (CVD) are the most significant cause of death in postmenopausal women. The loss of estrogen biosynthesis with advanced age is suggested as one of the major causes of higher CVD in postmenopausal women. While some studies show beneficial effects of estrogen therapy (ET)/hormonal replacement therapy (HRT) in the cardiovascular system of healthy postmenopausal women, similar studies in diabetic counterparts contradict these findings. In particular, ET/HRT in diabetic postmenopausal women results in a seemingly detrimental effect on the cardiovascular system. In this review, the comparative role of estrogens is discussed in the context of CVD in both healthy and diabetic postmenopausal women in regard to the synthesis or expression of proinflammatory molecules like advanced glycation end products (AGEs), receptor for advanced glycation end products (RAGEs), inducible nitric oxide synthases (iNOS) and the anti-inflammatory endothelial nitric oxide synthases (eNOS). The interaction of AGE-RAGE signaling with molecular nitric oxide (NO) may determine the level of reactive oxygen species (ROS) and influence the overall redox status of the vascular microenvironment that may further determine the ultimate outcome of the effects of estrogens on the CVD in healthy versus diabetic women.

Diabetes Mellitus↗