ORIGINAL ARTICLES   

International Angiology 2003 September;22(3):222-8

Copyright © 2003 EDIZIONI MINERVA MEDICA

lingua: Inglese

Influence of the hormonal changes during the normal menstrual cycle in healthy young women on soluble adhesion molecules, plasma homocysteine, free radical markers and lipoprotein fractions

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.