Estrogen deprivation, rather than age, is responsible for the poor lipid profile and carbohydrate metabolism in women.

UNLABELLED: The protective effect of estrogen against cardiovascular diseases (CVD) in women disappears after menopause. However, it is not clear whether the change in risk factors after menopause is related to aging or estrogen deprivation. OBJECTIVE: To assess the risks for CVD and the contribution of aging in estrogen-deprived women. METHODS: Forty-one patients with premature ovarian failure (POF) (group 1) and 30 patients with natural menopause (group 2) were investigated with respect to well-known risk factors for CVD. Fifteen young women at reproductive age (group 3) were taken as controls. The median ages (ranges) of the groups were 31 (19-40), 52 (46-67) and 26 (24-29) years, respectively. Family and personal history for CVD, smoking, oral contraceptive usage, physical examination, blood pressure measurement, body mass index (BMI), blood level of fasting insulin, diabetes mellitus, and the levels of lipoprotein proteins were the examined parameters regarding the risks for CVD. RESULTS: The levels of triglycerides and very low density lipoprotein (VLDL) cholesterol were not different in the 3 groups. The levels of fasting insulin (11.3 +/- 6.6 vs. 10.2 +/- 5.8 IU/ml), the ratio of fasting insulin to fasting blood glucose (12.2 +/- 6.3% vs. 10.5 +/- 5.4%), high density lipoprotein (HDL) cholesterol (51.9 +/- 12.9 vs. 51.6 +/- 9.7 mg/d), low density lipoprotein (LDL) cholesterol (113 +/- 47 vs. 127 +/- 37 mg/dl) and the ratio of HDL to total cholesterol (27.2 +/- 9.8% vs. 24.1 +/- 6.9%) were not different in women with POF and natural menopause. These parameters were all better in controls with respect to risk for CVD (respectively, 6.5 +/- 2.0 IU/ml, 7.4 +/- 2.2%, 37.9 +/- 5.3 mg/dl, 80 +/- 40 mg/dl, P < 0.05). CONCLUSION: Risk factors for CVD are related to estrogen deprivation. Aging does not have an important impact on CVD within the age range of this study group.

The concentration of plasma atrial natriuretic peptide in normotensive and preeclamptic pregnancies.

UNLABELLED: Atrial natriuretic peptide (ANP) is a family of peptides secreted by the heart, affecting the cardiovascular, renal and endocrine systems. This study questions previous research findings regarding elevated ANP levels, despite vasoconstriction and hypovolemia, in preeclamptic patients. MATERIALS AND METHODS: Seventeen patients with preeclampsia, 5 with superimposed preeclampsia with chronic hypertension and 17 normotensive pregnant women were compared with respect to plasma ANP levels. Seventeen non-pregnant women were taken as the control group. All the women, except the ones with superimposed preeclampsia, were age matched and in their third trimester. RESULTS: ANP levels in the non-pregnant women (6.9 +/- 0.7 pg/ml) were not different from those in the normotensive pregnant women (6.4 +/- 0.7 pg/ml). ANP levels were significantly higher in women with preeclampsia (10.8 +/- 1.8 pg/ml) or superimposed preeclampsia (9.7 +/- 1.4 pg/ml) than in normotensive pregnant women and normal non-pregnant women (P < 0.05). According to the literature, there is a volume depletion in preeclamptic women. However, this wasn't demonstrated in our study group. CONCLUSION: ANP levels in preeclamptic women were found to be higher than those in normotensive pregnant women. The etiology still remains obscure.

Change in atrial natriuretic peptide concentration after acute plasma volume expansion in normal pregnancy and preeclampsia.

Atrial natriuretic peptide (ANP) is found to be elevated in preeclamptic patients despite the presence of hemodynamic characteristics such as vasoconstriction and hypovolemia. In this study, the effect on ANP secretion of plasma volume expansion with crystalloid solutions was investigated. Seven preeclamptic and seven normotensive pregnant women in their last trimester were compared. After basal ANP measurements, 0.9% Ringer's solution, 15 cm3/kg body weight was infused within 30 min to expand the plasma volume. Blood sampling was repeated after the infusion. Maternal blood volume expansion was calculated from the decrease in hematocrit. Plasma ANP levels were corrected according to the degree of volume expansion. Basal mean levels in both groups were not different. Although the postinfusion levels of ANP in normotensive pregnant women were similar to the basal levels (means +/- SE: 20.6 +/- 0.41 and 27.2 +/- 0.52 pg/ml, respectively, p = 0.10), the postinfusion ANP levels in preeclamptic women increased significantly (21.4 +/- 0.31 and 34.1 +/- 0.28 pg/ml, respectively, p = 0.01). Preeclampsia is associated with a greater increase in plasma ANP levels in response to volume expansion compared with normotensive pregnancy. The greater change in the right atrial pressure with volume expansion, due to decreased compliance of the capacitance vessels in preeclamptic subjects might explain the greater change in the plasma level of ANP.