Sex Hormones and Their Relationship with Leptin and Cardiovascular Risk Factors in Pre and Post-Menopausal Nigerian Women with Metabolic Syndrome

Abstract

Metabolic Syndrome (MS), which affects 33.1% of Nigerians, predisposing them to cardiovascular disease (CVD) risk, has been associated with the female gender. The cardioprotective effect of oestradiol against CVD is now controversial and was investigated in premenopausal with MS (PRMMS) and postmenopausal women with MS (POMMS). A total of 191 women (44 PRMMS, 126 POMMS and 21 premenopausal women without MS (PRM) (controls) with mean (s.d) age of 40.0 (6.9), 57.0 (8.8), 29.0 (6.8) years were participants of this study. Demography, blood pressure (BP), anthropometry, hormones, fasting plasma glucose (FPG) and lipids were obtained by standard methods. Data were significant at (P<.05). Age, parity, all anthropometric measures, FPG, leptin, ET ratio and FSH were significantly higher while HDLC, testosterone and prolactin were significantly lower in PRMMS compared with controls (P<.03). In comparison of POMMS with PRMMS, age, parity, WHR, systolic BP, TG, FSH and LH were significantly higher while body weight, HC, and leptin were lower in POMMS compared with PRMMS (P<.05). DBP positively predicted oestradiol in PRM only (P=.044) while oestradiol positively predicted testosterone in PRMMS only (P<.001). In POMMS only, DBP positively predicted testosterone; testosterone, ET ratio and FSH positively predicted oestradiol while LDLC and oestradiol positively predicted the ET ratio (P<.03). Metabolic syndrome may predispose both pre and postmenopausal women to the risk cardiovascular disease and type 2 diabetes mellitus. Oestradiol may protect against cardiovascular diseases in women without metabolic syndrome only.

Reproductive function in premenopausal African Blacks with metabolic syndrome: Associations among inhibin B, adipokines, pituitary and sex hormones and sex hormone binding globulin

“…The visceral adipose tissue secretes leptin, an adipocytokine associated with the processes of inflammation, endothelial dysfunction, hypertension and atherogenesis. Increased levels of leptin in cases when compared with controls (P<0.05), observed in this present study has been previously reported (Fabian et al, 2015). DBP had a positive relationship with leptin in the control group only (P<0.05).…”

“…The increase in FSH levels in the cases compared with the controls (P<0.05) may suggest compensatory hypogonadism in the cases. As women approach menopause, FSH levels fall, ovarian follicular activity decreases, leading to decline in oestrogen level (Fabian et al, 2015). There is the resultant gradual loss of hormonal feedback mechanisms leading to the compensatory elevation of FSH for adequate production of oestradiol.…”

“…DBP also had a positive relationship with SHBG and testosterone in the control group only (P<0.05). Cardioprotective mechanisms are not fully understood (Charles-Davies et al, 2014), However, the cardioprotection of premenopausal women without MS only, has been postulated (Fabian et al, 2015). The possible mechanism may be that SHBG production is stimulated by oestrogen and inhibited by androgens indicating that a high level of SHBG would moderate the unfavourable effects of free androgens on blood pressure (Ding et al, 2006).…”

“…Leptin and adiponectin are adipocyte-derived hormones. Elevated leptin levels reflect increased adiposity in individuals with MS, being higher in premenopausal women than controls (Fabian et al, 2011;2015). Hypoadiponectinemia is associated with obesity particularly visceral fat accumulation, insulin resistance and MS. Adiponectin levels vary little during the menstrual cycle (Hall et al, 2009).…”

“…FAI is a surrogate marker for free testosterone and a determinant of abnormal androgen status in women (Rosner et al, Famuyiwa et al 85 2007;Fraser and Farrokh, 2014). Elevated FSH, reduced testosterone levels and elevated ETR suggestive of increased conversion of testosterone to oestradiol by aromatase in increased adipose tissue has been reported in pre-menopausal women with MS (Fabian et al, 2015). Inhibin B is a heterodimeric gonadal peptide secreted by granulosa cells of the ovary, negatively regulates follicule stimulating hormone (Grodstein et al, 1994).…”