Endogenous estradiol contributes to vascular endothelial dysfunction in premenopausal women with type 1 diabetes

Cardiovascular Diabetology

Research

Jennifer Waller¹  Matthew S. Nicholson²  Ahmed Elmarakby³  Karim M. Saad³  Cassandra C. Derella⁴  Marsha Blackburn⁴  Abigayle B. Simon⁴  Jeffrey Thomas⁴  Ryan A. Harris⁴  Lawrence C. Layman⁵ 

[1] Department of Biostatistics and Data Science, Medical College of Georgia, Augusta University, Augusta, GA, Georgia;Department of Endocrinology, Medical College of Georgia, Augusta University, Augusta, GA, Georgia;Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia, Augusta University, Augusta, GA, Georgia;Georgia Prevention Institute, Medical College of Georgia, Augusta University, 1120 15th Street, HS-1707, 30912, Augusta, GA, Georgia;Section of Reproductive Endocrinology, Infertility, & Genetics, Department of Obstetrics & Gynecology, Medical College of Georgia, Augusta University, Augusta, GA, Georgia;

关键词: Diabetes;    Endothelial function;    Estrogen;    Oral contraceptives;   

DOI  :  10.1186/s12933-023-01966-6

 received in 2023-06-08, accepted in 2023-08-14,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundEndogenous estrogen is cardio-protective in healthy premenopausal women. Despite this favorable action of estrogen, animal models depict a detrimental effect of estradiol on vascular function in the presence of diabetes. The present study sought to determine the role of endogenous estradiol on endothelial function in women with type 1 diabetes.Method32 women with type 1 diabetes (HbA1c = 8.6 ± 1.7%) and 25 apparently healthy women (HbA1c = 5.2 ± 0.3%) participated. Flow-mediated dilation (FMD), a bioassay of nitric-oxide bioavailability and endothelial function was performed during menses (M) and the late follicular (LF) phase of the menstrual cycle to represent low and high concentrations of estrogen, respectively. In addition, a venous blood sample was collected at each visit to determine circulating concentrations of estradiol, thiobarbituric acid reactive substances (TBARS), and nitrate/nitrite (NOx), biomarkers of oxidative stress and nitric oxide, respectively. Data were collected in (1) 9 additional women with type 1 diabetes using oral hormonal birth control (HBC) (HbA1c = 8.3 ± 2.1%) during the placebo pill week and second active pill week, and (2) a subgroup of 9 demographically matched women with type 1 diabetes not using HBC (HbA1c = 8.9 ± 2.1%).ResultsOverall, estradiol was significantly increased during the LF phase compared to M in both type 1 diabetes (Δestradiol = 75 ± 86 pg/mL) and controls (Δestradiol = 71 ± 76 pg/mL); however, an increase in TBARS was only observed in patients with type 1 diabetes (ΔTBARS = 3 ± 13 µM) compared to controls (ΔTBARS = 0 ± 4 µM). FMD was similar (p = 0.406) between groups at M. In addition, FMD increased significantly from M to the LF phase in controls (p = 0.024), whereas a decrease was observed in type 1 diabetes. FMD was greater (p = 0.015) in patients using HBC compared to those not on HBC, independent of menstrual cycle phase.ConclusionEndogenous estradiol increases oxidative stress and contributes to endothelial dysfunction in women with diabetes. Additionally, HBC use appears to be beneficial to endothelial function in type 1 diabetes.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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