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雌激素补充后内皮依赖性血管舒张改善的性别差异。

Gender difference in improvement of endothelium-dependent vasodilation after estrogen supplementation.

作者信息

Kawano H, Motoyama T, Kugiyama K, Hirashima O, Ohgushi M, Fujii H, Ogawa H, Yasue H

机构信息

Division of Cardiology, Kumamoto University School of Medicine, Japan.

出版信息

J Am Coll Cardiol. 1997 Oct;30(4):914-9. doi: 10.1016/s0735-1097(97)00234-9.

DOI:10.1016/s0735-1097(97)00234-9
PMID:9316518
Abstract

OBJECTIVES

We examined whether there is a gender difference in the improvement of endothelium-dependent vasodilation after estrogen supplementation.

BACKGROUND

Estrogen therapy reduces the risk of cardiovascular events in postmenopausal women, and the augmented release of endothelium-derived nitric oxide (NO) by estrogens has been suggested to be one of the mechanisms for the cardioprotective effects of estrogen.

METHODS

With ultrasound technique, we measured the diameter and blood flow of the brachial artery at rest, during reactive hyperemia after transient occlusion and after nitroglycerin administration before and after estradiol supplementation in 15 postmenopausal women (mean 63 years) and in 15 men matched for age and risk factors for atherosclerosis.

RESULTS

Estradiol supplementation augmented the flow-mediated vasodilation and serum level of nitrite/nitrate (metabolites of NO) in women (respectively, from mean +/- SEM of 8.0 +/- 0.6% to 12.9 +/- 0.6% [p < 0.01 by analysis of variance (ANOVA)] and from 64.9 +/- 8.7 to 93.7 +/- 9.4 mumol/liter [p < 0.05 by ANOVA]) but not in men (respectively, from 8.1 +/- 0.6% to 8.3 +/- 0.7% and from 57.8 +/- 6.7 to 60.8 +/- 5.4 mumol/liter). The increases in blood flow during reactive hyperemia and in diameter after nitroglycerin administration were not affected by estradiol supplementation in either men or women.

CONCLUSIONS

Estradiol supplementation improves endothelium-dependent vasodilation in women, probably because of augmented NO production/release, but not in men. Thus, there may be gender differences in the effects of estrogen therapy on endothelial functions and NO production/release.

摘要

目的

我们研究了雌激素补充后内皮依赖性血管舒张功能改善方面是否存在性别差异。

背景

雌激素疗法可降低绝经后女性心血管事件的风险,雌激素增加内皮源性一氧化氮(NO)释放被认为是雌激素心脏保护作用的机制之一。

方法

采用超声技术,我们在15名绝经后女性(平均63岁)和15名年龄及动脉粥样硬化危险因素相匹配的男性补充雌二醇前后,测量了静息状态下、短暂闭塞后反应性充血期间以及硝酸甘油给药后的肱动脉直径和血流量。

结果

补充雌二醇可增强女性血流介导的血管舒张以及亚硝酸盐/硝酸盐(NO的代谢产物)的血清水平(分别从平均±标准误的8.0±0.6%增至12.9±0.6%[方差分析(ANOVA),p<0.01],以及从64.9±8.7增至93.7±9.4μmol/升[ANOVA,p<0.05]),但男性无此变化(分别从8.1±0.6%增至8.3±0.7%,以及从57.8±6.7增至60.8±5.4μmol/升)。反应性充血期间的血流量增加以及硝酸甘油给药后的直径增加在男性和女性中均不受雌二醇补充的影响。

结论

补充雌二醇可改善女性的内皮依赖性血管舒张,可能是由于NO生成/释放增加,但男性并非如此。因此,雌激素疗法对内皮功能及NO生成/释放的影响可能存在性别差异。

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