Relations between serum sex hormone levels and biomarkers of atherosclerosis and mineral disturbances in postmenopausal chronic haemodialysis women

Objectives : Both cardiovascular calcification and atherosclerosis are strong predictors of cardiovascular events in patients with end-stage renal disease. The aim of our study was to assess the presence and interrelations of sex hormone profile with coronary artery calcification (CAC), atherosclerotic plaques (AP) in the carotid artery and common carotid artery intima media thickness (CCA-IMT) in postmenopausal chronic haemodialysis (HD) women.

Material and methods : CCA-IMT and presence and thickness of AP were measured with high-resolution ultrasound and CAC with multidetector computed tomography in a cross-sectional study of 22 postmenopausal HD women without any history of major cardiovascular complications. Serum mineral parameters, lipids, estradiol, progesterone and testosterone were also measured.

Results : The CAC was detected in 72% of examined women. Mean CAC score in HD women was 770 ±1065 Agatston units. Mean thickness of CCA-IMT was 0.94 ±0.23 mm. The women who did not develop vascular calcification had lower CCA-IMT. In women without CAC the serum level of estradiol was significantly lower than in those with detectable CAC (28.2 ±8.2 vs 61.5 ±18.4 pg/mL). There was a tendency for higher serum estradiol in HD women with atherosclerotic lesions in the common carotid artery. Strong correlations between the serum level of estradiol and, respectively CAC score, CCA-IMT and AP were observed. We did not find any significant differences between anthropometric parameters, other laboratory parameters, progesterone, testosterone and the presence of cardiovascular complications.

Conclusions: The study results do not support the concept of cardiovascular protective effects of endogenous estrogens in postmenopausal chronic haemodialysis women.