Metabolic syndrome in postmenopausal women: the influence of oral or transdermal estradiol on inflammation and coagulation markers.
OBJECTIVE
The objective of the study was to determine whether the route of administration of estrogen therapy in women with metabolic syndrome (MBS) influences inflammation and coagulation parameters.


METHODS
Fifty symptomatic postmenopausal women with MBS were randomized to receive 1 mg oral estradiol (oE(2)) or 0.05 mg transdermal E(2) (tE(2)) for 3 months. Measurements were compared with those of 20 healthy premenopausal women and 74 normal postmenopausal women.


RESULTS
Compared with both control groups, women with MBS had significantly higher levels of certain inflammation and coagulation markers, which cannot be accounted for based on weight alone. After oE(2), antithrombin III decreased from 104% to 96% (P < .01), the metalloproteinase-9/ tissue inhibitor of metalloproteinase-1 ratio increased (P < .02), and E-selectin decreased from 60 +/- 4.4 to 55 +/- 4.6 ng/mL (P < .05). With tE(2), there were no major changes noted.


CONCLUSIONS
Postmenopausal women with MBS have higher levels of certain coagulation and inflammation markers and different responses to oral compared with transdermal estradiol.
Department of Obstetrics, Columbia University College of Physicians and Surgeons, New York, NY, USA. mchu@nshs.edu
Micheline C
MC
Chu
Mary
M
Cushman
Rachel
R
Solomon
Rogerio A
RA
Lobo
D000279:Administration, Cutaneous; D000284:Administration, Oral; D000328:Adult; D000991:Antithrombins / Q000032:analysis; D015415:Biomarkers / Q000097:blood*; D001777:Blood Coagulation; D002097:C-Reactive Protein / Q000032:analysis; D018932:Chemokine CCL2 / Q000097:blood; D019040:E-Selectin / Q000097:blood; D004958:Estradiol / Q000008:administration & dosage*; D015914:Estrogen Replacement Therapy / Q000379:methods; D005167:Factor VII / Q000032:analysis; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005340:Fibrinogen / Q000032:analysis; D006801:Humans; D007249:Inflammation; D015850:Interleukin-6 / Q000097:blood; D020780:Matrix Metalloproteinase 9 / Q000097:blood; D024821:Metabolic Syndrome / Q000378:metabolism*; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D017698:Postmenopause; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000097:blood
D000991:Antithrombins; D015415:Biomarkers; C111835:CCL2 protein, human; D018932:Chemokine CCL2; D019040:E-Selectin; D005338:Fibrin Fibrinogen Degradation Products; D015850:Interleukin-6; D017395:Plasminogen Activator Inhibitor 1; D019715:Tissue Inhibitor of Metalloproteinase-1; C036309:fibrin fragment D; D004958:Estradiol; D005167:Factor VII; D005340:Fibrinogen; D002097:C-Reactive Protein; D020780:Matrix Metalloproteinase 9