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Vitamin D and estradiol help guard against heart disease, stroke, and diabetes

Vitamin D and estrogen have already shown well-documented results in improving bone health in women. A new study from China suggests that this same combination could help prevent metabolic syndrome, a constellation of conditions that increases the risk of heart disease, stroke, and diabetes in postmenopausal women. Results are published online today in Menopause, the journal of The North American Menopause Society (NAMS).

Metabolic syndrome has emerged as a major public health concern, affecting 30% to 60% of postmenopausal women worldwide. The progression of abdominal obesity and heart disease that lead to metabolic syndrome increases significantly as women age and appears to be directly associated with estrogen loss in postmenopausal women. This has led some researchers to recommend estradiol treatment for women who are fewer than 6 years postmenopausal as a means of preventing heart disease.

Similarly, vitamin D has been associated with several markers of metabolic syndrome, including obesity, hyperglycemia, insulin resistance, and type 2 diabetes mellitus. Supplementation with vitamin D has been shown to reduce the risk of metabolic syndrome over a 20-year follow-up.

Because the synergistic benefits of vitamin D and estrogen are already documented to improve bone health in women, researchers in this newest study from China hypothesized that the same interaction might affect metabolic syndrome. The cross-sectional study included 616 postmenopausal women aged 49 to 86 years who were not taking estrogen and vitamin D/calcium supplements at the beginning of the trial. It concluded there was a positive correlation between vitamin D and estradiol.

Specifically, higher vitamin D was associated with a favorable lipid profile, blood pressure, and glucose level. Estradiol was negatively associated with cholesterol, triglycerides, and blood pressure. These results suggest a synergistic role of vitamin D and estradiol deficiency in developing metabolic syndrome in postmenopausal women.

Findings are published in the article "The synergistic effects of vitamin D and estradiol deficiency on metabolic syndrome in Chinese postmenopausal women."

"In this cross-sectional study, low estradiol increased the risk of metabolic syndrome in postmenopausal women who had vitamin D deficiency," says Dr. JoAnn Pinkerton, NAMS executive director. "The Endocrine Society recommends vitamin D levels of 30 ng/mL for postmenopausal women. Whether adequate levels of vitamin D improve nonskeletal cardiovascular or cognitive benefits remains the subject of debate, and answers await randomized clinical trial data."

Abstract

Objective:

Recent studies show that vitamin D (VitD) deficiency is associated with metabolic syndrome (MetS). Current evidence suggests that estrogen and VitD have similar physiological functions and potentially interact with bone health. We investigated the association between estradiol (E2) and 25-hydroxyvitamin-D [25(OH)D] with MetS and its components in Chinese postmenopausal women.

Methods:

In this cross-sectional study, we examined 616 postmenopausal women (aged 49-86 y) from southern China who were not taking estrogen and VitD/calcium supplements. At the end of data collection, serum E2 and 25(OH)D were measured for each participant. MetS was defined according to the 2006 International Diabetes Federation standard. 

Results:

There was a positive correlation between 25(OH)D and E2. Higher 25(OH)D was associated with a favorable lipid profile, blood pressure, and glucose level. E2 was negatively associated with cholesterol, triglycerides, and blood pressure. The odds ratio for MetS was 2.19 (95% CI, 1.19-4.01, P value for trend=0.009) for deficient compared with sufficient women after multivariable adjustment. This association remained unchanged after further adjusting for E2 levels. After stratified analysis by VitD status, low E2 increased MetS risk in women with VitD deficiency (odds ratio = 3.49, 95% CI, 1.45-8.05 for the lowest vs the highest tertile).

Conclusions:

These results suggest a synergistic role of VitD and E2 deficiency in MetS in Chinese postmenopausal women.

Reference

Huang H, Guo J, Chen Q, Chen X, Yang Y, Zhang W, Liu Y, Chen X, Yang D. The synergistic effects of vitamin D and estradiol deficiency on metabolic syndrome in Chinese postmenopausal women.  Menopause. 2019 Jun 10. doi: 10.1097/GME.0000000000001370. [Epub ahead of print]

 

Content created 23 June 2019

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