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

Am J Obstet Gynecol. 2008 Nov;199(5):526.e1-7. doi: 10.1016/j.ajog.2008.04.033. Epub 2008 Jun 3.

Abstract

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 (oE(2)) or 0.05 mg transdermal E(2) (tE(2)) 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 oE(2), 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 tE(2), 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.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Cutaneous
  • Administration, Oral
  • Adult
  • Antithrombins / analysis
  • Biomarkers / blood*
  • Blood Coagulation*
  • C-Reactive Protein / analysis
  • Chemokine CCL2 / blood
  • E-Selectin / blood
  • Estradiol / administration & dosage*
  • Estrogen Replacement Therapy* / methods
  • Factor VII / analysis
  • Female
  • Fibrin Fibrinogen Degradation Products / analysis
  • Fibrinogen / analysis
  • Humans
  • Inflammation*
  • Interleukin-6 / blood
  • Matrix Metalloproteinase 9 / blood
  • Metabolic Syndrome / metabolism*
  • Middle Aged
  • Plasminogen Activator Inhibitor 1 / blood
  • Postmenopause
  • Tissue Inhibitor of Metalloproteinase-1 / blood

Substances

  • Antithrombins
  • Biomarkers
  • CCL2 protein, human
  • Chemokine CCL2
  • E-Selectin
  • Fibrin Fibrinogen Degradation Products
  • Interleukin-6
  • Plasminogen Activator Inhibitor 1
  • Tissue Inhibitor of Metalloproteinase-1
  • fibrin fragment D
  • Estradiol
  • Factor VII
  • Fibrinogen
  • C-Reactive Protein
  • Matrix Metalloproteinase 9