Estradiol and follicle-stimulating hormone imbalance associated with mineral-bone metabolism disturbances and cardiovascular complications in women on hemodialysis
N. G. Malakhova,
F. U. Dzgoeva,
O. V. Remizov,
V. H. Botsieva,
Z. R. Ikoeva,
V. G. Goloeva,
E. Yu. Gireyeva,
L. V. Tsallagova,
A. E. Gurina https://doi.org/10.36485/1561-6274-2022-26-3-72-79
Abstract
BACKGROUND. The influence of female sex hormones on the regulation of the processes of formation and resorption of bone tissue, as well as the effect of excess or deficiency of sex hormones on renal function is associated with the development of cardiovascular complications in patients at different stages of chronic kidney disease.
THE AIM: to study the relationship between estradiol deficiency and excess FSH content with disorders of mineral and bone metabolism and cardiovascular complications in postmenopausal women on hemodialysis.
PATIENTS AND METHODS. 119 women from 34 to 57 years old on hemodialysis were examined. The concentration of follicle-stimulating hormone (FSH) and estradiol2, sclerostin, and fibroblast growth factor 23 (FGF-23) was determined using a sandwich-variant solid-phase ELISA on a «Multiscan EX analyzer» («ThermoFisher Scientific Inc.», Finland) with kits of «Alkor-Bio Company» (Russian Federation) and sets of "sandwich" type manufactured by Cloud-Clone Corp., USA. Echocardiography was performed using an «ALOKA 4000 Aplio» (Toshiba, Japan) in Doppler mode. Determined the left ventricular ejection fraction (LVEF), peak systolic velocity in the aortic arch (Vps – peak systolic velocity); LV myocardial mass index (LVMI). Left ventricular hypertrophy (LVH) was defined with LVMI greater than 95 g /m2 in women.
RESULTS. There was a direct correlation between high levels of FSH and high levels of sclerostin, FSH, and FGF23, an inverse correlation between low levels of estradiol2 and sclerostin, estradiol2 and FGF23, expressed in groups of patients with more severe changes in LVMI and Vps. CONCLUSION. In women on hemodialysis, bone mineral and cardiovascular abnormalities are associated with both renal failure proper and changes in the system of female sex hormones. A decrease in estradiol levels causes an increase in the nephrotoxic FSH and contributes to the excessive synthesis of sclerostin, a key factor in bone-mineral and cardiovascular complications in CKD.
About the Authors
N. G. Malakhova
North Ossetian State Medical Academy
Russian Federation
Russian Federation
Nina G. Malakhova
Department of Obstetrics and Gynecology № 1
362040
st. Pushkinskaya, 40
Republic of North Ossetia–Alania
Vladikavkaz
tel.: + 79888386237
F. U. Dzgoeva
North Ossetian State Medical Academy
Russian Federation
Russian Federation
Fatima U. Dzgoeva, Prof., Dr. med. Sciences
Department of Internal Diseases № 5
362040
st. Pushkinskaya, 40
Republic of North Ossetia–Alania
Vladikavkaz
tel.: 8 918 822 83 45
O. V. Remizov
North Ossetian State Medical Academy
Russian Federation
Russian Federation
Oleg V. Remizov, prof., Dr. med. Sciences
Department of Radiation Diagnostics with Radiation Therapy and Oncology
362040
Republic of North Ossetia–Alania
Vladikavkaz
tel.: (8 867) 530397
V. H. Botsieva
North Ossetian State Medical Academy
Russian Federation
Russian Federation
Victoria Kh. Botsieva, postgraduate student
Department of Biochemistry
362040
st. Pushkinskaya, 40
Republic of North Ossetia–Alania
Vladikavkaz
tel.: +79288573355
Z. R. Ikoeva
North Ossetian State Medical Academy
Russian Federation
Russian Federation
Zarina R. Ikoeva, postgraduate student
Department of Internal Diseases № 5
362040
st. Pushkinskaya, 40
Republic of North Ossetia–Alania
Vladikavkaz
tel.: +79188304719
V. G. Goloeva
North Ossetian State Medical Academy
Russian Federation
Russian Federation
Victoria G. Goloeva, postgraduate student
Department of Internal Diseases № 5
362040
st. Pushkinskaya, 40
Republic of North Ossetia–Alania
Vladikavkaz
tel.: +79604015003
E. Yu. Gireyeva
North Ossetian State Medical Academy
Russian Federation
Russian Federation
Elena Yu. Gireeva, Associate Professor, Candidate of Medical Sciences
Department of Internal Diseases № 5
362040
st. Pushkinskaya, 40
Republic of North Ossetia–Alania
Vladikavkaz
tel.: +79284972808
L. V. Tsallagova
North Ossetian State Medical Academy
Russian Federation
Russian Federation
Larisa V. Tsallagova, Prof., Dr. med. Sciences, Head of the Department
Department of Obstetrics and Gynecology № 1
362040
Republic of North Ossetia–Alania
st. Pushkinskaya, 40
Vladikavkaz
tel.: +79188278686
A. E. Gurina
North Ossetian State Medical Academy
Russian Federation
Russian Federation
Alla E. Gurina, Associate Professor, Ph.D. honey. Sciences, Head of the Department
Department of Biochemistry
362040
st. Pushkinskaya, 40
Republic of North Ossetia–Alania
Vladikavkaz
tel.: +79188258355
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Review
For citations:
Malakhova N.G., Dzgoeva F.U., Remizov O.V., Botsieva V.H., Ikoeva Z.R., Goloeva V.G., Gireyeva E.Yu., Tsallagova L.V., Gurina A.E. Estradiol and follicle-stimulating hormone imbalance associated with mineral-bone metabolism disturbances and cardiovascular complications in women on hemodialysis. Nephrology (Saint-Petersburg). 2022;26(3):72-79. (In Russ.) https://doi.org/10.36485/1561-6274-2022-26-3-72-79
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