HT reduces inflammation biomarkers for women in early menopause
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A 1 mg dose of estradiol reduced biomarkers of inflammation tied to atherosclerosis in postmenopausal women — particularly those in early menopause — participating in the Early vs. Late Intervention Trial with Estradiol.
“Daily intake of hormone therapy reduced generalized inflammation indicated by reduction of multiple biomarkers of inflammation in women within 6 years of menopause,” Roksana Karim, PhD, MBBS, associate professor of clinical preventive medicine at the University of Southern California, told Healio. “Anti-inflammatory effect of HT could be a potential mechanism of anti-atherosclerotic benefit from HT in healthy postmenopausal women within 6 years of menopause.”
Karim presented study findings at the North American Menopause Society virtual meeting.
To evaluate the impact of HT on a woman’s risk for atherosclerosis, which increases after menopause, researchers analyzed data on the effect of HT on biomarkers of inflammation in 535 healthy, postmenopausal women participating in the Early vs. Late Intervention Trial with Estradiol (ELITE; mean age, 60.6 years; 68.4% white). Participants were divided into an early postmenopause group, defined as those who were within 6 years of menopause (n = 227), and a late postmenopause group for women who were 10 years or more removed from menopause (n = 308).
Trial participants were randomly assigned to an oral 1 mg dose of 17-beta-estradiol for a mean time of 5 years or placebo. Researchers measured 12 inflammatory biomarkers from stored serum samples in participants at baseline, 12 months and 36 months of follow-up.
Compared with the placebo group, participants who received HT had average decreased levels of E-selectin (mean difference, –0.131; P = .0002), intercellular adhesion molecule-1 (ICAM-1) (mean difference, –0.037; P = .03), interferon gamma (mean difference, –0.144; P = .03) and interleukin-8 (mean difference, –0.249; P = .03).
Early postmenopause women in the HT group also had lower mean levels of E-selectin (mean difference, –0.135; P = .01), ICAM-1 (mean difference, –0.07; P = .008) and IL-8 (mean difference, –0.487; P = .004) vs. those in the placebo group. Late postmenopause participants in the HT group had a larger drop only in E-selectin (mean difference, –0.126; P = .006) when compared with placebo.
“ELITE primary results support the timing hypothesis of menopausal hormone therapy,” Karim said. “The current results support the ELITE primary results. These findings are encouraging for clinical practice of HT, which is primarily considered to alleviate menopausal symptoms, and is showing anti-inflammatory benefit as well in healthy women early in postmenopause.”
Karim added that more research must be done in a more diverse population to strengthen the findings. She also said other routes of HT administration must be investigated for cardiovascular benefit that address the timing hypothesis of HT in menopause.
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Karim R, et al. Effect of estradiol therapy on markers of inflammation: Results from the Early vs. Late Intervention Trial with Estradiol (ELITE). Presented at: North American Menopause Society Annual Meeting; Sept. 28, 2020 (virtual meeting).
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