Hormone Therapy Improves Lipid Profile and Oxidative Stress in Postmenopausal Women with Metabolic Syndrome

by | Jan 21, 2019 | 2016, Blood Lipids, Metabolic Syndrome, Women's Health

Written by Angeline A. De Leon, Staff Writer. Six months of hormone therapy significantly improved lipid profiles in postmenopausal women and markers of oxidative stress in both healthy postmenopausal women and those with metabolic syndrome.

blood lipidsMetabolic syndrome is characterized by a collection of conditions-namely, increased blood pressure, high blood sugar, abdominal obesity, insulin resistance, and abnormal cholesterol or triglyceride levels-which increase the risk of heart disease, stroke, and/or diabetes. Postmenopausal status is associated with increased risk of metabolic syndrome 1, due to the increased abdominal adiposity and lower energy expenditure associated with reduced estrogen levels 2. Estrogen possesses anti-oxidative properties 3, therefore, lower levels of the hormone during the postmenopausal period corresponds to diminished antioxidant capacity. Indeed, menopause has been identified as a risk factor for oxidative stress 4, and studies show a link between excessive oxidative stress in postmenopausal women and metabolic syndrome 5. Hormone replacement therapy, primarily using estrogen and progestin, was designed to alleviate symptoms of menopause in women. Although largely still controversial, research suggests this therapy may benefit women with metabolic syndrome by significantly reducing insulin resistance, visceral fat, and hypertension 2. In a 2016 study published in the International Journal of Molecular Sciences, researchers sought to evaluate the effects of oral hormone therapy on oxidative stress in postmenopausal women with metabolic syndrome.

A randomized, double-blind, placebo-controlled trial 6 was carried out with a group of 100 postmenopausal women (aged 45 to 59 years) with or without metabolic syndrome in Mexico City, Mexico. Participants were divided into four groups: healthy women receiving hormone therapy (1 mg/day of estradiol valerate, along with 5 mg/10 d of medroxiprogesterone), healthy women receiving placebo treatment, women with metabolic syndrome receiving hormone therapy, and women with metabolic syndrome receiving placebo treatment. At baseline and at 3-month and 6-month follow-up, anthropometric measurements and blood pressure readings were taken and fasting blood samples were collected for analysis of glucose, cholesterol, and triglyceride levels. Researchers also assessed plasma lipid peroxide (LPO), erythrocyte superoxide dismutase (SOD) and glutathione peroxidase (Gpx), total plasma antioxidant status, and uric acid as markers of oxidative stress. A total oxidative stress score was calculated on a scale of 0 to 7, based on the severity of the biomarkers modifications.

After 6 months of treatment, hormone therapy was shown to significantly reduce triglyceride concentration (2.42 +/- 0.18 vs. 2.02 +/- 0.17 mmol/L, p < 0.05) in women with metabolic syndrome. Hormone therapy also significantly reduced low-density lipoprotein cholesterol concentration in healthy women (3.0 +/- 0.16 vs. 2.5 +/- 0.13 mmol/L, p = 0.001) and those with metabolic syndrome (3.5 +/- 0.26 vs. 2.6 +/- 0.24 mmol/L, p < 0.001). At 6-month follow-up, hormone therapy was seen to improve LPO (p < 0.0001), GPx (p < 0.0001), SOD/GPx ratio (p < 0.0001), and antioxidant gap (p < 0.05) in women with metabolic syndrome. In healthy women, hormone therapy improved LPO (p < 0.0001) and GPx (p < 0.001) concentrations. At 3-month follow-up, total oxidative stress score declined from 3.8 +/- 0.3 to 1.7 +/- 0.3 (p < 0.05) in women with metabolic syndrome who were treated with hormone therapy. No such changes were detected in the placebo groups.

According to the data, oral hormone therapy with estrogen exhibits an ability to improve lipid profile and oxidative stress in postmenopausal women with metabolic syndrome. Although the use of hormone therapy remains controversial, in the context of the present study, results show that hormone therapy can improve individual markers of oxidative stress in healthy women and those with metabolic syndrome, as well as total oxidative stress score (composed of both oxidant and antioxidant markers) in women with metabolic syndrome. Although the present study suffers from a relatively small sample size, its use of a double-blind trial design is helpful in controlling potential biases. Replication of study findings would be useful, particularly prospective trials involving a longer observation period and a study sample of women at different stages of menopause.

Source: Sanchez-Rodriguez MA, Zacarias-Flores M, Castrejon-Delgado L, et al. Effects of hormone therapy on oxidative stress in postmenopausal women with metabolic syndrome. International Journal of Molecular Sciences. 2016; 17: 1388. DOI:10.3390/ijms17091388.

© 2016 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/).

Click here to read the full text study.

Posted January 21, 2019.

Angeline A. De Leon, MA, graduated from the University of Illinois at Urbana-Champaign in 2010, completing a bachelor’s degree in psychology, with a concentration in neuroscience. She received her master’s degree from The Ohio State University in 2013, where she studied clinical neuroscience within an integrative health program. Her specialized area of research involves the complementary use of neuroimaging and neuropsychology-based methodologies to examine how lifestyle factors, such as physical activity and meditation, can influence brain plasticity and enhance overall connectivity.

References:

  1. Jouyandeh Z, Nayebzadeh F, Qorbani M, Asadi M. Metabolic syndrome and menopause. Journal of Diabetes & Metabolic Disorders. 2013;12(1):1.
  2. Korljan B, Bagatin J, Kokić S, Matulić NB, Ostojić SB, Deković A. The impact of hormone replacement therapy on metabolic syndrome components in perimenopausal women. Medical hypotheses. 2010;74(1):162-163.
  3. Kumar S, Lata K, Mukhopadhyay S, Mukherjee TK. Role of estrogen receptors in pro-oxidative and anti-oxidative actions of estrogens: a perspective. Biochimica et Biophysica Acta (BBA)-General Subjects. 2010;1800(10):1127-1135.
  4. Sánchez-Rodríguez MA, Zacarías-Flores M, Arronte-Rosales A, Correa-Muñoz E, Mendoza-Núñez VM. Menopause as risk factor for oxidative stress. Menopause. 2012;19(3):361-367.
  5. Holvoet P, Keyzer DD, Jacobs Jr D. Oxidized LDL and the metabolic syndrome. Future Lipidology. 2008;3(6):637-649.
  6. Sánchez-Rodríguez MA, Zacarías-Flores M, Castrejón-Delgado L, Ruiz-Rodríguez AK, Mendoza-Núñez VM. Effects of hormone therapy on oxidative stress in postmenopausal women with metabolic syndrome. International journal of molecular sciences. 2016;17(9):1388.