Cardiometabolic Health: Do Sex Steroids Matter?

[madman]

"Cardiometabolic Health: Do Sex Steroids Matter?" which looks at the role sex steroids play in cardiovascular health across the lifespan.

My team who have contributed to the work presented

 

[madman]

Both estrogens and testosterone have vital roles in women and men

 

[madman]

Key aspect I will address

 

[madman]

Ovarian failure before the age of 45 years

 

[madman]

Estrogen has MAJOR CARDIOMETABOLIC EFFECTS that are not gender specific

 

[madman]

Mice unable to make estrogen (aromatase gene knock out) (total estrogen depletion)

 

[madman]

* To my knowledge there have been four men identified who have aromatase gene mutation and this is one of these men we studied a number of years ago




29 yo MAN with complete estrogen deficiency (aromatase gene mutation)

Estradiol patch reversed the manifestations of insulin resistance/dyslipidemia

 

[madman]

Estrogen directly effects vascular endothelial & smooth-muscle cells

 

[madman]

Cardiometabolic changes seen in postmenopausal women

Postmenopausal estrogen therapy has known cardiometabolic benefits

 

[madman]

So, estrogen should prevent cardiometabolic disease after menopause, but does it?

The Women's health initiative [WHI] Studies were designed in the 1990's to determine whether estrogen prevents CHD

Noteworthy, not a selected low risk study sample

WHI: Oral estrogen + progestin users had less self-reported incident T2 diabetes

* The graphs are impressive but the devils always in the detail

Factors associated with incident diabetes in WHI estrogen + progestin study

Estrogen + progestin: no reduction in CHD (MI/CHD death) despite small reduction in self-reported incident diabetes