Menopausal status and current usage of oral contraceptives and hormone replacement therapy in relationship to soluble concentrations of adhesion molecules
Epidemiological studies have shown that hormone replacement therapy (HRT) generally reduces coronary heart disease mortality in post-menopausal women. A smaller number of reports also indicate that oral contraceptive (OC) use provides some cardioprotective effects. However, the mechanisms by which these commonly-used exogenous hormones affect the vascular system are not entirely known and comparisons to males are not always made. We measured the circulating concentrations of four inflammatory markers [intracellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), E-selectin (ESEL), and P-selectin (PSEL)] in 281 healthy men and 307 healthy women (204 pre-menopausal, 103 post-menopausal) aged 18-85 years. Individuals were grouped according to sex, and in women, menopausal status (pre/post), OC use (yes/no), and HRT use (yes/no). The effects of these variables on adhesion molecule concentrations were examined using analysis of variance, adjusting for smoking, age, body mass index, and waist-hip ratio. The means shown are ± standard error and the values are in ng/ml. We found significantly higher mean ICAM-1 concentrations in post-menopausal women (358±15) than in pre-menopausal women (317±15) and men (295±10), p<0.01. ESEL was significantly higher in men (61±2) and post-menopausal women (63±3) than in pre-menopausal women (54±2), p<0.05. Similarly, there was a tendency for VCAM-1 and PSEL to be higher in post-menopausal women and men compared to pre-menopausal women, although these contrasts were not statistically significant. Among pre-menopausal women, OC users (N=59) had lower mean VCAM-1 and E-SEL concentrations than those not using OC (N=145)(VCAM-1: 494±47 vs. 644±29, p<0.001 and ESEL 42±4 vs..54±2, p<0.005). Among post-menopausal women, those using HRT (N=52) had lower ICAM-1 and VCAM-1 than those not using HRT (N=51) (ICAM-1: 342±26 vs. 408±24, p<0.05 and VCAM-1: 682±89 vs. 790±82, p=0.15). We conclude that current use of OC and HRT is associated with a beneficial effect on the expression of certain inflammatory markers.