Relationship between the severity of endothelial dysfunction and metabolic disorders and the severity of climacteric syndrome


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Aim. Investigation of the character and extent of changes in endothelial functional activity and metabolic disorders (visceral obesity and insulin resistance, lipid imbalance) in climacteric women, depending on severity of climacteric syndrome (CS). Materials and methods. The study included 168 women in perimenopause and 216 women in early perimenopause with CS. Modified Kupperman-Uvarova menopausal index was assessed. The parameters of lipid metabolism, fasting blood glucose, the level of immunoreactive insulin (IRI) and the HOMA-IR index were assessed. Waist circumference was measured and Waist-Hip Ratio (WHR) was calculated. Flow-dependent vasodilation (FDV) of brachial artery was assessed using the reactive hyperemia test. Enzyme immunoassay was used to assess the levels of endothelial dysfunction (ED) markers - endothelin-1 (ET-1, nitric oxide metabolites, von Willebrand factor antigen (V WF:Ag) and asymmetric dimethylarginine (ADMA) in blood plasma. Results. Significant disturbance of endothelial function was found in women with moderate and severe symptoms of CS in comparison to the women with mild disease: the change in brachial artery diameter (10.1±5.2% versus 12.2±6.5% (р<0.01)) and lower level of NO2 metabolites (12.1fiml/l (10,3;13,8) versus 13.8) μml/l (12.2;15.3, respectively (р=0,042). Along with more severe abdominal obesity and IRI, the progressive intensity of vasomotor symptoms of CS was noted. In women with severe CS compared to a mild disease, obesity and dyslipidemia were more frequent (in 60.2% versus 40% of patients, p<0.001), as well as the metabolic syndrome (in 58.7% versus 41.3%, respectively (p<0.01)). Conclusion. The severity of CS was associated with significant metabolic changes and endothelial dysfunction. The severity of the vasomotor symnptoms of CS may reflect the severity of ED in menopausal women.

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Sobre autores

Sergey Tolstov

V.I. Razumovsky Saratov State Medical University, Ministry of Health of Russia; Regional Clinical Cardiological Dispensary

Email: tolstovsn@mail.ru
Dr. Med. Sci., Professor of the Department of Therapy with Courses in Cardiology, Functional diagnostics and Geriatrics Saratov, Russia

Igor Salov

V.I. Razumovsky Saratov State Medical University, Ministry of Health of Russia

Email: salov.i.a@mail.ru
Dr. Med. Sci., Professor, Head of Оbstetrics and Gynecology Department Saratov, Russia

Andrey Rebrov

V.I. Razumovsky Saratov State Medical University, Ministry of Health of Russia

Email: andreyrebrov@yandex.ru
Dr. Med. Sci., Professor, Head of Hospital Therapy Department Saratov, Russia

Bibliografia

  1. Newson L. Menopause and cardiovascular disease. Post Reprod. Health. 2018; 24(1): 44-9. https://dx.doi.org/10.1177/2053369117749675.
  2. Baber R.J., Panay N., Fenton A.; IMS Writing Group. 2016 IMS Recommendations on women's midlife health and menopause hormone therapy. Climacteric. 2016; 19(2): 109-50. https://dx.doi.org/10.3109/13697137.2015.1129166.
  3. Юренева С.В., Ильина Л.М., Сметник В.П. Старение репродуктивной системы женщин: от теории к клинической практике. Часть I. Эндокринные и клинические характеристики стадий репродуктивного старения женщин. Акушерство и гинекология. 2014; 3: 21-7.
  4. Pinkerton J.V. Hormone therapy for postmenopausal women. N. Engl. J. Med. 2020; 382(5): 446-55. https://dx.doi.org/10.1056/NEJMcp1714787.
  5. Avis N.E., Crawford S.L., Greendale G., Bromberger J.T., Everson-Rose S.A., Gold E.B. et al. Study of Women's Health Across the Nation. Duration of menopausal vasomotor symptoms over the menopause transition. JAMA Intern. Med. 2015; 175(4): 531-9. https://dx.doi.org/10.1001/jamainternmed.2014.8063.
  6. Collins P., Webb C.M., de Villiers T.J., Stevenson J.C., Panay N., Baber R.J. Cardiovascular risk assessment in women - an update. Climacteric. 2016; 19(4): 329-36. https://dx.doi.org/10.1080/13697137.2016.1198574.
  7. Thurston R.C. Vasomotor symptoms: natural history, physiology, and links with cardiovascular health. Climacteric. 2018; 21(2): 96-100. https://dx.doi.org/10.1080/13697137.2018.1430131.
  8. Gast G.C., Pop V.J., Samsioe G.N., Grobbee D.E., Nilsson P.M., Keyzer J.J. et al. Vasomotor menopausal symptoms are associated with increased risk of coronary heart disease. Menopause. 2011; 18(2): 146-51.
  9. Biglia N., Cagnacci A., Gambacciani M., Lello S., Maffei S., Nappi R.E. Vasomotor symptoms in menopause: a biomarker of cardiovascular disease risk and other chronic diseases? Climacteric. 2017; 20(4): 306-12. https://dx.doi.org/10.1080/13697137.2017.1315089.
  10. Tuomikoski P., Savolainen-Peltonen H. Vasomotor symptoms and metabolic syndrome. Maturitas. 2017; 97: 61-5. https://dx.doi.org/10.1016/j.maturitas.2016.12.010.
  11. Svartberg J., von Mühlen D., Kritz-Silverstein D., Barrett-Connor E. Vasomotor symptoms and mortality: the Rancho Bernardo Study. Menopause. 2009; 16(5): 888-91. https://dx.doi.org/10.1097/gme.0b013e3181a4866b.
  12. Dam V., Dobson A.J., Onland-Moret N.C., van der Schouw Y.T., Mishra G.D. Vasomotor menopausal symptoms and cardiovascular disease risk in midlife: A longitudinal study. Maturitas. 2020; 133: 32-41. https://dx.doi.org/10.1016/j.maturitas.2019.12.011.
  13. Muka T., Oliver-Williams C., Colpani V., Kunutsor S., Chowdhury S., Chowdhury R. et al. Association of vasomotor and other menopausal symptoms with risk of cardiovascular disease: a systematic review and meta-analysis. PLoS One. 2016; 11(6): e0157417. https://dx.doi.org/10.1371/journal.pone.0157417.
  14. Szmuilowicz E.D., Manson J.E., Rossouw J.E., Howard B.V., Margolis K.L, Greep N.C. et al. Vasomotor symptoms and cardiovascular events in postmenopausal women. Menopause. 2011; 18(6): 603-10. https://dx.doi.org/10.1097/gme.0b013e3182014849.
  15. Harlow S.D., Gass M., Hall J.E., Lobo R., Maki P., Rebar R.W. et al.; STRAW 10 Collaborative Group. Executive summary of the Stages of Reproductive Aging Workshop + 10: addressing the unfinished agenda of staging reproductive aging. Menopause. 2012; 19(4): 387-95. https://dx.doi.org/10.1097/gme.0b013e31824d8f40.
  16. Вихляева Е.М. Руководство по эндокринной гинекологии. М.: МИА; 2006. 784с.
  17. Tuomikoski P., Ebert P., Groop P.H., Haapalahti P., Hautamäki H., Rönnback M. et al. Effect of hot flushes on vascular function: a randomized controlled trial. Obsteto Gynecol. 2009; 114(4): 777-85. https://dx.doi.org/10.1097/AOG.0b013e3181b6f268.
  18. Martinez Perez J.A., Palacios S., Chavida F., Perez M. Severity of menopausal symptoms and cardiovascular and osteoporosis risk factors. Climacteric. 2013; 16(2): 226-34. https://dx.doi.org/10.3109/13697137.2012.688077.
  19. Zhu D., Chung H.F., Dobson A.J., Pandeya N., Anderson D.J., Kuh D. et al. Vasomotor menopausal symptoms and risk of cardiovascular disease: a pooled analysis of six prospective studies. Am. J. Obstet. Gynecol. 2020; 223(6): 898. e1-898. e16. https://dx.doi.org/10.1016/j.ajog.2020.06.039.
  20. Kaya C., Cengiz H., Ye§il A., Ekin M., Yasar L. The relation among steroid hormone levels, lipid profile and menopausal symptom severity. J. Psychosom. Obste.t Gynaecol. 2017; 38(4): 284-91. https://dx.doi.org/10.1080/0167482X.2017.1321633.
  21. Thurston R.C., Chang Y., Barinas-Mitchell E., Jennings J.R., von Känel R., Landsittel D.P. et al. Physiologically assessed hot flashes and endothelial function among midlife women. Menopause. 2018; 25(11): 1354-61. https://dx.doi.org/10.1097/GME.0000000000001239.

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