Influence of estradiol deficiency on the mineralocorticoid receptor response in postmenopausal women: a cross-sectional study.

IF 2.9 4区医学 Q1 OBSTETRICS & GYNECOLOGY

Climacteric Pub Date : 2025-04-01 Epub Date: 2025-02-10 DOI:10.1080/13697137.2025.2455181

Alejandra Martínez-García, Jorge A Pérez, Alejandra Tapia-Castillo, María P Hernández, Marlin Solórzano, Pablo Carrión, Carlos E Fardella, Cristian A Carvajal

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引用次数: 0

Abstract

Objective: Premenopausal women (PreM) have a cardioprotective advantage over postmenopausal women (PostM) due to estrogen. The interaction of estrogen with the mineralocorticoid receptor (MR) pathway remains unexplored. This study aimed to identify changes in aldosterone, renin and sexual steroid levels and MR surrogate biomarkers in PostM that may explain changes in blood pressure and renal damage.

Methods: A cross-sectional study was carried out with 47 normotensive and hypertensive Chilean women distributed between PreM and PostM. Clinical, anthropometric and biochemical parameters, including aldosterone, plasma renin activity (PRA) and surrogate markers of MR activity, were assessed.

Results: PostM had greater systolic blood pressure (SBP) (p < 0.001) than PreM. A negative correlation was observed between estradiol and fractional excretion of potassium (FEK) (ρ = -0.29; p = 0.023), adjusted for age and SBP. Compared with hypertensive PreM, hypertensive PostM (PostM-HT) showed reduced PRA (p = 0.045) and greater FEK (p = 0.04). Normotensive PostM (Post-NT) exhibited greater SBP (p = 0.03), neutrophil gelatinase-associated lipocalin (NGAL) levels (p = 0.04) and FEK (p = 0.03) than normotensive PreM.

Conclusion: Our results suggest enhanced MR sensitivity not only in PostM-HT, as evidenced by lower PRA and elevated FEK, but also in PostM-NT, who exhibited greater FEK and NGAL levels, surrogate markers of MR activation. These results support a novel role of MR activation and cardiovascular risk in PostM women.

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雌二醇缺乏对绝经后妇女矿皮质激素受体反应的影响：一项横断面研究

目的：由于雌激素的作用，绝经前妇女（PreM）比绝经后妇女（PostM）具有心脏保护优势。雌激素与矿物皮质激素受体（MR）途径的相互作用仍未被探索。本研究旨在确定后发期中醛固酮、肾素和性类固醇水平以及MR替代生物标志物的变化，这些变化可能解释血压和肾损害的变化。方法：采用横断面研究方法对47名智利正常血压和高血压妇女进行研究，这些妇女分布在孕前和产后。评估临床、人体测量和生化参数，包括醛固酮、血浆肾素活性（PRA）和MR活性替代标志物。结果：术后患者收缩压（SBP）升高(p ρ = -0.29；p = 0.023)，根据年龄和收缩压进行调整。与高血压PreM相比，高血压PostM （post - ht）患者PRA降低（p = 0.045）， FEK升高（p = 0.04）。正常血压的PostM （Post-NT）比正常血压的prem表现出更高的收收压（p = 0.03）、中性粒细胞明胶酶相关脂钙素（NGAL）水平（p = 0.04）和FEK （p = 0.03）。结论：我们的研究结果表明，不仅在PostM- ht中表现出更低的PRA和更高的FEK，而且在PostM- nt中表现出更高的FEK和NGAL水平，这是MR激活的代标志物。这些结果支持一个新的作用，磁共振激活和心血管风险后妇女。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Climacteric 医学-妇产科学

CiteScore

1.70

自引率

7.10%

发文量

审稿时长

1 months

期刊介绍： Climacteric is the official journal of the International Menopause Society (IMS). As an international peer-reviewed journal it publishes original research and reviews of all aspects of aging in women. Climacteric was founded by the IMS in 1998 and today has become a leading journal in the publication of peer-reviewed papers on the menopause, climacteric and mid-life health. Topics covered include endocrine changes, symptoms attributed to the menopause and their treatment, hormone replacement and alternative therapies, lifestyles, and the counselling and education of peri- and postmenopausal women. Climacteric, published bimonthly, also features regular invited reviews, editorials and commentaries on recent developments. The editorial review board of Climacteric includes leading scientific and clinical experts in the field of midlife medicine and research and is headed by its Editor-in-Chief, Professor Rod Baber of Australia. He and his team of Associate Editors act independently to set a clear editorial policy, co-ordinate peer review, and ensure a rapid response to submitted papers.