Ren Zi, Guo Jiayi, Xiao Xingxing, Huang Jiana, Li Manchao, Cai Ruibin, Zeng Haitao
Center for Reproductive Medicine, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, China.
Division of Emergency Medicine, Department of Emergency Intensive Care Unit, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China.
Cardiol Res Pract. 2020 Sep 21;2020:2132918. doi: 10.1155/2020/2132918. eCollection 2020.
Men have a higher risk and earlier onset of cardiovascular diseases compared with premenopausal women. Hypertriglyceridemia is an independent risk factor for the occurrence of ischemic heart disease. Endothelial dysfunction is related to the development of ischemic heart disease. Whether sex differences will affect the circulating endothelial progenitor cells (EPCs) and endothelial function in hypertriglyceridemia patients or not is not clear.
Forty premenopausal women and forty age- and body mass index (BMI)-matched men without cardiovascular and metabolic disease were recruited and then divided into four groups: normotriglyceridemic women (women with serum triglycerides level <150 mg/dl), hypertriglyceridemic women (women with serum triglycerides level ≥150 mg/dl), normotriglyceridemic men (men with serum triglycerides level <150 mg/dl), and hypertriglyceridemic men (men with serum triglycerides level ≥150 mg/dl). Peripheral blood was obtained and evaluated. Flow-mediated dilatation (FMD), the number and activity of circulating EPCs, and the levels of nitric oxide (NO), vascular endothelial growth factor (VEGF), and granulocyte-macrophage colony-stimulating factor (GM-CSF) in plasma and culture medium were measured.
The number and activity of circulating EPCs, as well as the level of NO in plasma or culture medium, were remarkably increased in premenopausal females compared with those in males both in the hypertriglyceridemic group and the normotriglyceridemic group. The EPC counts and activity, as well as the production of NO, were restored in hypertriglyceridemic premenopausal women compared with those in normal women. However, in hypertriglyceridemic men, the EPC counts and activity, as well as levels of NO, were significantly reduced. The values of VEGF and GM-CSF were without statistical change.
The present study firstly demonstrated that there were sex differences in the number and activity of circulating EPCs in hyperglyceridemia patients. Hypertriglyceridemic premenopausal women displayed restored endothelial functions, with elevated NO production, probably mediated by estradiol. We provided a new insight to explore the clinical biomarkers and therapeutic strategies for hypertriglyceridemia-related vascular damage.
与绝经前女性相比，男性患心血管疾病的风险更高且发病更早。高甘油三酯血症是缺血性心脏病发生的独立危险因素。内皮功能障碍与缺血性心脏病的发展有关。尚不清楚性别差异是否会影响高甘油三酯血症患者循环内皮祖细胞（EPCs）和内皮功能。
招募40名无心血管和代谢疾病的绝经前女性以及40名年龄和体重指数（BMI）匹配的男性，然后将其分为四组：正常甘油三酯血症女性（血清甘油三酯水平<150mg/dl的女性）、高甘油三酯血症女性（血清甘油三酯水平≥150mg/dl的女性）、正常甘油三酯血症男性（血清甘油三酯水平<150mg/dl的男性）和高甘油三酯血症男性（血清甘油三酯水平≥150mg/dl的男性）。采集外周血并进行评估。测量血流介导的血管舒张（FMD）、循环EPCs的数量和活性以及血浆和培养基中一氧化氮（NO）、血管内皮生长因子（VEGF）和粒细胞-巨噬细胞集落刺激因子（GM-CSF）的水平。
在高甘油三酯血症组和正常甘油三酯血症组中，绝经前女性循环EPCs的数量和活性以及血浆或培养基中NO的水平均显著高于男性。与正常女性相比，高甘油三酯血症绝经前女性的EPC计数和活性以及NO的产生恢复正常。然而，在高甘油三酯血症男性中，EPC计数和活性以及NO水平显著降低。VEGF和GM-CSF的值无统计学变化。
本研究首次表明，高甘油血症患者循环EPCs的数量和活性存在性别差异。高甘油三酯血症绝经前女性的内皮功能恢复，NO产生增加，可能由雌二醇介导。我们为探索高甘油三酯血症相关血管损伤的临床生物标志物和治疗策略提供了新的见解。
