ATHEROSCLEROSIS RISK FACTORS IN WOMEN DURING MENOPAUSE

Sunchica Petrovska; Beti Dejanova; Sanja Manchevska; Jasmina Pluncevic Gligorova

Sunchica Petrovska Institute of Physiology, Medical faculty, University Ss.“Cyril and Methodius”, Skopje
Beti Dejanova Institute of Physiology, Medical faculty, University Ss.“Cyril and Methodius”, Skopje
Sanja Manchevska Institute of Physiology, Medical faculty, University Ss.“Cyril and Methodius”, Skopje
Jasmina Pluncevic Gligorova Institute of Physiology, Medical faculty, University Ss.“Cyril and Methodius”, Skopje

Abstract

The loss of female sex hormones after menopause contributes to the striking increase in the incidence of cardiovascular morbidity and mortality. The present study was designed to evaluate some of the artherosclerotic risk factors: LDL-C, HDL-C and factor VII of coagulation, in women during menopause.

The study comprised a number of 77 women divided into three groups. The control group included 25 healthy women in their reproductive period. The perimenopausal group consisted of 27 women, with FSH level under 25mU/ml, and with anamnestic data of irregularity of menstrual cycle. The postmenopausal group encompassed 25 women regarding lack of cycle for more than 12 months. Hormone level was determined with RIA method. Lipid level was determined with standard colorimetric-spectrophotometric method and the concentration of f. VII was determined by method of plasma deficiency.

Statistical analysis has shown that there was a significant increase of LDL-C and factor VII in both perimenopausal and postmenopausal examines in comparison with the control group (p<0,001).

This study favours the view that decrease in estradiol level and associated increase in LDL-CH and factor VII seen in perimenopausal and postmenopausal women may be responsible for the increased risk of atherosclerotic thromboemembolic complications in women during the most vulnerable period of their life.

References

1. Villablanca AC, Jayachandran M, Banka C. Atherosclerosis and sex hormones: current concepts. Clin Sci (Lond). 2010; 119(12):493-513.
2. Stefanik ML. Postmenopausal hormone therapy and cardiovascular disease in women. Nutr Metab Cardiovasc Dis.2010; 20 ( 6): 451-8
3. Park JS, Jung HH, Yang WS, Kim SB, Min WK, Chi HS. Effect on hormonal replacement therapy on lipid and haemostatic factors in post-menopausal ESRD patients. Nephrol Dial Transplant. 2000 Nov; 15(11):1835-40.
4. Mudali S, Dobs AS, Ding J, et al, 2005 Endogenous postmenopausal hormones and serum lipids: the atherosclerosis risk in communities study. J Clin Endocrinol Metab 90: 1202 - 9.
5. Bruschi F, Meschia M, Soma M, Perotti D, Paoletti R, Crosignani PG, 1996 Lipoprotein(a) and other lipids after oophorectomy and estrogen replacement therapy. Obstet Gynecol 88: 950-4.
6. Demissie S, Cupples LA, Shearman AM, et al, 2006 Estrogen receptor-alpha variants are associated with lipoprotein size distribution and particle levels in women: the Framingham Heart Study. Atherosclerosis 185: 210-18.
7. Mayes JS, Watson GH, 2004 Direct effects of sex steroid hormones on adipose tissues and obesity. Obes Rev 5: 197-216.
8. Palin SL, McTernan PG, Anderson LA, Sturdee DW, Barnett AH, Kumar S, 2003 17Beta-estradiol and anti-estrogen ICI: compound 182,780 regulate expression of lipoprotein lipase and hormone-sensitive lipasein isolated subcutaneous abdominal adipocytes. Metabolism 52: 383-8.
9. Pascot A, Despres JP, Lemieux I, et al, 2001 Deteriora-tion of the metabolic risk profile in women. Respective contributions of impaired glucose tolerance and visceral fat accumulation. Diabetes Care 24: 902 - 8.
10. Cífková R, Krajčoviechová A. Dyslipidemia and cardiovascular disease in women. Curr Cardiol Rep. 2015 Jul; 17(7): 609.
11. Bracamonte MP, Miller VM, 2001 Vascular effects of estrogens: arterial protection versus venous thrombotic risk. Trends Endocrinol Metab 12: 204-9.
12. Grady D, Wenger NK, Herrington D, et al, 2000 Post-menopausal hormone therapy increases risk for venous thromboembolic disease. The Heart and Estrogen/progestin Replacement Study. Ann Intern Med 132: 689-96.
13. Anderson GL, Limacher M, Assaf AR, et al. Women’s Health Initiative Steering Committee 2004 Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: the Women’s Health Initiative randomized controlled trial. JAMA 291: 1701- 12.
14. GomesMP, Deitcher SR. Risk of venousthrombo-embolic disease associated with hormonal contraceptives and hormonereplacement therapy:aclinicalreview. Arch Intern Med 2004; 164: 1965-76.
15. Straczek C, Oger E, Yon de Jonage-Canonico MB, et al. Estrogen and Thromboembolism Risk (ESTHER) Study Group. Prothromboticmutations, hormone therapy, and venous thromboembolism among postmenopausal women: impact of the route of estrogen administration. Circulation 2005; 112: 3495-500.
16. Lisowski P, Małyszko J, Lisowska A, Czech B, Myśliwiec M, Jackowski R, Hirnle T.Role of the hemostatic system in pathogenesis of atherosclerosis as the main etiology of coronary ischemia. Pol Merkur Lekarski. 2004; 16(95):465-7.
17. Hellgren M, Conard J, Norris L, Kluft C. Cardiovascular risk markers during treatment with estradiol and trimegestone or dydrogesterone. Maturitas. 2009;62(3):287-93.
18. Polotsky HN, Polotsky AJ. Metabolic implications of menopause. Semin Reprod Med. 2010; 28(5):426-34.
19. Evola G, Novo G, Amoroso G, Guttilla D, Lo Coco L, Guagliardo M, Lupo A, Averna MR, Giambanco V, Miller V, Novo S. Modification of the lipidic and coagulative pattern in postmenopause women: effect of hormone replacement therapy. Int Angiol. 2010; 29(4):355-61.
20. Gaeta G, Lanero S, Barra S, Silvestri N, Cuomo V, Materazzi C, Vitagliano G. Sex hormones and lipoprotein (a) concentration. Expert Opin Investig Drugs. 2011;20(2):221-38.