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

Abstract

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/m²) 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/m²) 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.

Keywords:

• Obesity
• estrogen replacement therapy
• menopause
• atherosclerosis
• estradiol

Conflict of interest

The authors have no conflict of interest to disclose. The authors alone are responsible for the content and writing of this paper.

Source of funding

This study was supported by grants from the National Council for Scientific and Technological Development (CNPq) and the Carlos Chagas Filho Foundation for Research Support in the State of Rio de Janeiro (FAPERJ). These Agencies had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.