TY - JOUR
T1 - Interleukin-6 and flow-mediated dilatation as markers of increased vascular inflammation in women receiving hormone therapy
AU - Vitale, Cristiana
AU - Cornoldi, Alessandra
AU - Gebara, Otavio
AU - Silvestri, Antonello
AU - Wajngarten, Mauricio
AU - Cerquetani, Elena
AU - Fini, Massimo
AU - Ramires, J. A F
AU - Rosano, G. M C
PY - 2005
Y1 - 2005
N2 - Objective: The lack of a beneficial long-term cardiovascular effect of hormone therapy and the early incidence of cardiovascular adverse events observed in recent randomized studies have been related to a heightened inflammatory effect of hormone therapy. Design: We evaluated the effect of different postmenopause therapies on inflammatory markers and endothelial function in 205 postmenopausal women before and after therapy. Results: In all postmenopausal women, estrogens alone increased plasma levels of C-reactive protein (CRP) but decreased all other markers of inflammation including interleukin-6 (IL-6) (CRP: +75% ± 11%, intracellular adhesion molecule: -21% ± 4%, vascular cell adhesion molecule: -15% ± 6%, E-selectin: -18% ± 4%, s-thrombomodulin -10.5% ± 3.7%, IL-6 -14% ± 6%; percent changes, P <0.01 compared with baseline). Raloxifene and tibolone did not significantly affect the overall inflammatory milieu. In a minority of patients, estrogen-progestogen associations and tibolone increased IL-6 levels and induced unfavorable changes on inflammation markers (CRP: +93% ± 8%, intracellular adhesion molecule: -3% ± 2%, vascular cell adhesion molecule: -5% ± 2%, E-selectin: +6% ± 2%, s-thrombomodulin: +5% ± 2%, IL-6: +12% ± 4%; percent changes compared with baseline). Patients with increased IL-6 levels were older and had a longer time since menopause. In all patients except those with increased IL-6 levels, hormone therapy improved endothelial function, whereas tibolone and raloxifene did not significantly change endothelial function compared with baseline. A worsening of endothelial function was detected in patients with increased IL-6 levels during therapy. Conclusions: Postmenopausal hormone therapy is associated with decreased vascular inflammation; however, in patients with a longer time since menopause, postmenopause hormone therapy may increase inflammation and worsen endothelial function. These unfavorable vascular effects may be detected by an elevation in IL-6 levels and by a lack of improvement in endothelial function.
AB - Objective: The lack of a beneficial long-term cardiovascular effect of hormone therapy and the early incidence of cardiovascular adverse events observed in recent randomized studies have been related to a heightened inflammatory effect of hormone therapy. Design: We evaluated the effect of different postmenopause therapies on inflammatory markers and endothelial function in 205 postmenopausal women before and after therapy. Results: In all postmenopausal women, estrogens alone increased plasma levels of C-reactive protein (CRP) but decreased all other markers of inflammation including interleukin-6 (IL-6) (CRP: +75% ± 11%, intracellular adhesion molecule: -21% ± 4%, vascular cell adhesion molecule: -15% ± 6%, E-selectin: -18% ± 4%, s-thrombomodulin -10.5% ± 3.7%, IL-6 -14% ± 6%; percent changes, P <0.01 compared with baseline). Raloxifene and tibolone did not significantly affect the overall inflammatory milieu. In a minority of patients, estrogen-progestogen associations and tibolone increased IL-6 levels and induced unfavorable changes on inflammation markers (CRP: +93% ± 8%, intracellular adhesion molecule: -3% ± 2%, vascular cell adhesion molecule: -5% ± 2%, E-selectin: +6% ± 2%, s-thrombomodulin: +5% ± 2%, IL-6: +12% ± 4%; percent changes compared with baseline). Patients with increased IL-6 levels were older and had a longer time since menopause. In all patients except those with increased IL-6 levels, hormone therapy improved endothelial function, whereas tibolone and raloxifene did not significantly change endothelial function compared with baseline. A worsening of endothelial function was detected in patients with increased IL-6 levels during therapy. Conclusions: Postmenopausal hormone therapy is associated with decreased vascular inflammation; however, in patients with a longer time since menopause, postmenopause hormone therapy may increase inflammation and worsen endothelial function. These unfavorable vascular effects may be detected by an elevation in IL-6 levels and by a lack of improvement in endothelial function.
KW - Cardiovascular risk
KW - Endothelial function
KW - Estrogen
KW - Inflammation
KW - Menopause
KW - Prognosis
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U2 - 10.1097/01.gme.0000172267.24949.70
DO - 10.1097/01.gme.0000172267.24949.70
M3 - Article
C2 - 16145309
AN - SCOPUS:25444520226
VL - 12
SP - 552
EP - 558
JO - Menopause
JF - Menopause
SN - 1072-3714
IS - 5
ER -