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Effects of rosiglitazone on the cardiovascular profile in postmenopausal women without diabetes mellitus: interplay of thiazolidinediones and hormone therapy

Chen, I-Chih MD; Lee, Wen-Huang MD; Chao, Ting-Hsing MD; Li, Yi-Heng MD, PhD; Tsai, Wei-Chuan MD; Pan, Hsien-An MD, PhD; Tseng, Shih-Ya MS; Chen, Ju-Yi MD

Menopause:
doi: 10.1097/gme.0b013e3182400ec0
Original Articles
Abstract

Objective: Thiazolidinediones have antiatherothrombotic effects on persons with diabetes. Hormone therapy among postmenopausal women has both positive and negative cardiovascular effects. However, the effects of rosiglitazone with or without concurrent long-term hormone therapy on the cardiovascular profile of nondiabetic postmenopausal women are unknown.

Methods: Thirty-eight nondiabetic postmenopausal women were enrolled in this double-blind and placebo-controlled study. Eighteen participants received 4 mg rosiglitazone, and 20 participants took placebo daily for 12 weeks. Global endothelial function and plasma biomarkers were measured.

Results: Baseline characteristics and parameters were similar between the groups. Rosiglitazone, but not placebo, significantly reduced leukocyte count and plasma levels of matrix metalloproteinase-9 and inhibited the elevation of plasma levels of plasminogen activator inhibitor-1 and tissue plasminogen activator (P < 0.05 for all). Most of the favorable effects provided by rosiglitazone were still present in participants with concurrent hormone therapy. Increased body weight and waist size as well as elevation of the plasma levels of total and low-density lipoprotein cholesterol were noted after rosiglitazone treatment among participants without concurrent hormone therapy. No significant change in the global endothelial function occurred in response to treatment in either group.

Conclusions: Rosiglitazone treatment provided both protective and harmful cardiovascular effects in nondiabetic postmenopausal women. Concurrent hormone therapy resulted in the maintenance of the major beneficial effects while neutralizing the unfavorable effects of rosiglitazone.

In Brief

Rosiglitazone treatment provided both protective and harmful cardiovascular effects in this clinical setting. Concurrent hormone therapy resulted in the maintenance of major beneficial effects while neutralizing the unfavorable effects of rosiglitazone.

Author Information

From the 1Division of Cardiology, Department of Internal Medicine, National Cheng Kung University College of Medicine and Hospital, Tainan, Taiwan; 2Division of Cardiology, Department of Internal Medicine, Tainan Municipal Hospital, Tainan, Taiwan; 3Department of Internal Medicine, National Cheng Kung University Hospital Dou-Liou Branch, Yun-Lin County, Taiwan; 4Cardiovascular Research Center, National Cheng Kung University College of Medicine and Hospital, Tainan, Taiwan; 5Department of Obstetrics and Gynecology, National Cheng Kung University College of Medicine and Hospital, Tainan, Taiwan;and 6Department of Biological Science, National Sun Yat-Sen University, Kaohsiung, Taiwan.

Received September 11, 2011; revised and accepted November 2, 2011.

I-Chih Chen and Wen-Huang Lee have equally contributed to this study.

Funding/support: This study was supported by the National Cheng KungUniversity Hospital under grant number NCKUH-93-008, the Ministry of Education Program for Promoting Academic Excellent of Universities under grant number NSC 96-2752-B-006-005-PAE, and the Development Plan for World Class Universities and Research Centers ofExcellence under grant number D95-2200.

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Ting-Hsing Chao, MD, Division of Cardiology, Department of Internal Medicine, National Cheng Kung University College of Medicine and Hospital, No. 138, Sheng-Li Road, Tainan, Taiwan. E-mail: chaotinghsing@yahoo.com.tw

© 2012 by The North American Menopause Society.