Efeitos do uso de estradiol transdérmico em baixa dose sobre biomarcadores inflamatórios e função microcirculatória em mulheres com sobrepeso e obesidade grau I na pós-menopausa

• Autor(a) principal: Silva, Lucia Henriques Alves da
• Data de Publicação: 2014
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/12783
• topic: Hormonal menopause therapy; Endothelium; Inflammation; Microcirculation; Terapia hormonal da menopausa; Endotélio; Inflamação; Microcirculação; Menopausa Hormonioterapia; Pós-menopausa Efeito das drogas; Endotélio; Microcirculação; Obesidade; Estradiol; CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::ENDOCRINOLOGIA

Hormonal therapy (HT) is a modality of treatment to postmenopausal women with climacteric syndrome. Many positive effects beyond improvement on related signals and symptoms had been proven, as those observed in bone health and endothelial function. However, there are still doubts about which profile of patients would benefit after physiological plasmatic concentrations of estrogens are achieved, since HT was associated to cardiovascular undesirable events, especially in women with established atherosclerotic disease. The objective of this work was to evaluate the effect of the use of hormonal therapy with low-dose isolated transdermal estradiol in postmenopausal women with overweight and grade I obesity on inflammation biomarkers and microcirculatory function. 44 women who presented recent menopause, aged between 47 a 55 years and body mass index of 27,7 to 34,9 kg&#8725;m² were recruited. They were allocated, by external selection, into two groups: placebo (P) and transdermal estradiol (E). In this group, the volunteers used 1 mg of daily transdermal estradiol during three consecutive months. Plasma levels of inflammatory biomarkers (high sensitive reactive C protein, interleukin-1β, interleukin-6, monocyte chemotactic protein-1 and tumoral necrosis factor-α), vascular injury and repair biomarkers (activated and resting circulating endothelial cells and circulating progenitor cells) were quantified and microcirculatory function analyzed by laser Doppler flowmetry (LDF) before and after intervention. The patients had age of 51,77 ± 2,3 years, BMI of 31,52 ± 2,54 kg/m² and time since menopause of 3 [2-5] years. After intervention, we did not notice changes on inflammatory biomarkers in both groups. However, on the E group, a significant increase on levels of resting circulating endothelial cells and endothelial progenitor cells were observed. In addition, there was a trend toward improvement on endothelial component of vasomotricity (P < 0,057). Moreover, a lower cumulative dose to achieve the plateau maximal velocity after acetylcholine iontophoresis was necessary (P < 0,001) and an improvement on endothelial-independent vasodilation after sodium nitroprusside iontophoresis (P < 0,01) occurred. We did not observe changes in body composition or insulin sensitivity. In conclusion, in postmenopausal women studied, the proposed hormonal therapy did not modify plasma inflammatory biomarkers, but resulted in benefits on markers of vascular repair and microcirculatory reactivity.