The Relationship Between Sex Hormones, Endothelial Function, Serum Lipids And Severity Of Coronary Heart Disease In Postmenopausal Women

Background The strikingly lower prevalence of coronary heart disease (CHD) in premenopausal women than in men of similar age, the progressive narrowing of that difference with age after menopause, and an inability to explain the difference by known risk factors for CHD other than gender suggest an important role for sex hormones in the development of CHD. Blood vessel endothelium is a physiologic barrier between the circulation blood and vascular smooth muscle. Endothelial dysfunction is the origin of atherosclerosis(AS). Endothelial dysfunction(ED) is consist in the occurrence and development of atherosclerosis, prevention and control of endothelial dysfunction is becoming a new trend of prevent and cure CHD. While numerous cross-sectional and prospective studies on plasma sex hormone levels in relation to CHD have been performed in postmenopausal women and some studies have been confirmed that the level of estrogen decrease and it induces ED and the disorder of blood lipid of postmenopausal women might account for the increasing incidence of CHD, few data are available on sex hormones,endothelial function,serum lipids in relation to severity of coronary artery disease in postmenopausal women.Objective Through assessing the association about endogenous sex hormones, endothelial function, serum lipids and severity of coronary artery disease in postmenopausal women to demonstrate the effect of plasma sex hormone levels on vascular endothelial function,the effect of plasma sex hormone levels on serum lipids and making clear the protective effect and its pathway of estrogen on CHD.Methods According to the results of coronary angiography, 44postmenopausal women (normal menopause >1 year) with CHD [groupⅠ, average age was (64.01±0.56) years] and 36 postmenopausal women (normal menopause >1 year) without CHD [groupⅡ, average age was (63.51±0.75) years] were enrolled. According to the results of coronary angiographies, coronary lesion score were calculated Estradiol(E2) and progestone( P), as well as endothelin(ET-1), fasting blood glucose, serum lipids, apoprotein, endothelium-dependent dilation (flow-mediated dilation, FMD),and risk factors for CHD were measured.Result There was significant difference in E2 and P between the two groups, linear correlation analysis showed there was a significant negative correlation between E2 (r=-0.55, P<0.01), P(r=-0.32, P<0.01) and coronary lesion score, The higher level of estrogen was, the lower coronary lesion score was, the lighter coronary lesion degree was. Difference in ET-1, FDM% between CHD group and the control group was significan(tP <0.05). There was a significant positive correlation between E2 and FDM%. Correlation analysis showed there was a significant negative correlation between E2 and TC,TG,LDL-C, while a positive correlation existed between E2 and HDL-C,ApoA.Conclusion The incidence of CHD is related to the reduction of the estrogen in post-menopausal woman. Endothelial dysfunction was one of independent risk factors of CHD. Endogenous E2 plays an important role in maintaining normal Endothelial Function. There was a close correlation between reduction of the estrogen in postmenopausal women and dyslipidemia,ED and so on, which resulted in the onset of CHD.