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Official Journal of the , the International Union of Phlebology and the
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,899
Online ISSN 1827-1839
Elhadd T. A. 1, Neary R. 2, Abdu T. A. M. 1, Kennedy G. 3, Hill A. 3, McLaren M. 3, Akber M. 1, Belch J. J. F. 3, Clayton R. N. 1
1 Department of Medicine, North Staffordshire Hospital, Stoke-on-Trent, UK
2 Department of Clinical Biochemistry, North Staffordshire Hospital, Stoke-on-Trent, UK
3 Section of Vascular Medicine and Biology, University Department of Medicine Ninewells Hospital and Medical School, Dundee,UK
Aim. Female sex hormones are known to exert a protective role on the vascular endothelial function, but the exact mechanisms of such protection is not known. We aimed to study the possible regulatory role of the female sex hormones changes during the normal menstrual cycle on soluble adhesion molecules E-selectin and ICAM-1, plasma homocyteine, free radical markers and lipoproteins in healthy young women.
Methods. Experimental design: a cross sectional study of healthy female volunteers studied during a single normal menstrual cycle at 3 specific time points. Setting: North Staffordshire Hospitals NHS Trust. Subjects: 20 healthy young menstruating women, aged (mean±SEM) 34±1 years, with normal menstruation, defined as a menstrual cycle of 21-35 days were studied at 3 time points of the same menstrual cycle. First in the early follicular phase (M-phase), at mid-follicular phase (F-phase), and during the luteal phase (L-phase). Intervention: none. Measurement: serum levels of soluble E-selectin, ICAM-1, plasma homocysteine, vitamin E and malondialdehyde (MDA), as well as lipoprotein fractions were measured at each time points.
Results. The mean percentage change for E-selectin between the M-phase and L-phase, F-phase and L-phase were 6% and 4%, respectively, p<0.005, p<0.066. Levels of ICAM-1, vitamin E and malondialdehyde did not vary through the cycle. Homocysteine was not different between M-phase and F-phase (10.39±0.68 μmol/l vs 10.33±0.65), nor between M-phase and L-phase (10.39±0.68 vs 9.77±0.75 μmol/l). Although the mean percentage decrease in homocysteine between F- and L-phases was significant (5.36±0.53%, p=0.029), the absolute decrease in concentrations was not (p=0.07). There were no cyclical changes in total, LDL, HDL cholesterol, triglycerides, apo A-I, apo B or Lp(a). Using a linear regression model, after correction for age, smoking, body mass index (BMI) and waist/hip ratio (WHR), oestrogen levels were the only predictor of E-selectin during the L-phase p<0.005. There were no significant correlations between oestrogen with lipids, apolipoproteins or homocysteine. There was an interesting significant univariate correlation between homocysteine with low-density-lipoprotein (LDL) cholesterol and apo B throughout all phases of the cycle, which persisted after correction for the effects of age, BMI, WHR and smoking history. Multiple regression analysis with all these factors showed homocysteine to be a significant predictor of apo B concentration during M (p=0.030) and L-phases (p=0.023) of the cycle and of LDL cholesterol in the M-phase (p=0.033).
Conclusion. Female sex hormones may have small, though significant modulating role on E-selectin and homocysteine metabolism in healthy premenopausal women. Furthermore, the correlation between homocysteine, LDL and apo B levels suggests that induction of cholesterol synthesis by homocysteine, shown previously in vitro, may be of relevance in vivo.