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Departments of Medicine (M.B., V.V., M.J.T.) and Obstetrics and Gynecology (T.S.M., A.T.), Helsinki University Central Hospital, Haartmaninkatu 2, 00029 HUCH, Helsinki, Finland
Address all correspondence and requests for reprints to: Matti J. Tikkanen, M.D., Department of Medicine, Helsinki University Central Hospital, Haartmaninkatu 4, 00290 Helsinki, Finland. E-mail: matti.tikkanen{at}hus.fi.
| Abstract |
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Objective: Our objective was to determine the 17ß-estradiol fatty acid ester concentrations in serum and adipose tissue in women of various hormonal states.
Design: After several chromatographic steps separating esterified from free estradiol, time-resolved fluoroimmunoassay was used as a quantifying tool.
Participants: Samples were obtained from pregnant women undergoing cesarean section (n = 13), or premenopausal (n = 8) and postmenopausal women (n = 6) during gynecological surgery.
Main Outcome Measures: 17ß-Estradiol and 17ß-estradiol fatty acid ester concentrations in serum, and visceral and sc adipose tissue were examined.
Results: The ratio of esterified to free estradiol in plasma increased with decreasing estradiol level from 0.5% in pregnant, to 15% in premenopausal and 110% in postmenopausal women. Estradiol esters constituted about 10% of the free estradiol present in adipose tissue in pregnancy. In nonpregnant women, most of the adipose tissue estradiol was in esterified form, the median ester to free ratio being elevated to 150–490%. After menopause, the overwhelming majority of estradiol in both free and esterified form was present in adipose tissue.
Conclusions: The overall higher ester to free estradiol ratio in adipose tissue than in serum indicates active esterification capacity in adipose tissue. The predominance of esterified and free estradiol in postmenopausal adipose tissue compared with serum suggests in situ production and storage. Whether the estradiol esters have an independent physiological role in adipose tissue remains to be clarified.
| Introduction |
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The endogenously synthesized fatty acid esters of estradiol accumulate and are transported in lipoprotein particles in the circulation (12). In human plasma, high-density lipoprotein 3 (HDL3) associated lecithin-cholesterol acyltransferase (LCAT) esterifies estradiol with different long-chain fatty acids, and transport of these esters to low-density lipoprotein (LDL) is enhanced by cholesterol ester transfer protein (13, 14). LCAT is also responsible for estradiol esterification in ovarian follicular fluid (15). However, in other tissues, the mechanisms of estradiol ester formation are not as well established, but the enzyme systems responsible differ from that in the blood and are not identical with the one for cholesterol esterification (1, 16, 17).
Human adipose tissue is known to be an important source of estrogens in the postmenopausal physiological state characterized by low estrogen levels. The adipose tissue levels of estrogen precursor hormones (e.g. testosterone and androstenedione) exceed their concentrations in other tissues, and adipose tissue with its active aromatase and 17ß-hydroxysteroid dehydrogenase enzymes probably is an important site for estrogen formation at all ages (18). The adipose tissue is also regulated by estrogens, and the human adipose tissue has contained ERs
and ß, as well as different isoforms of the latter subtype (19, 20), the expression of which proposedly could influence hormonal effects on adipose tissue deposition (20).
The estradiol fatty acid esters present in adipose tissue may exert independent functions or simply serve as a hormone reservoir. Using mass spectrometric methods, estradiol fatty acid ester concentrations exceeding those in serum have been measured in human and bovine adipose tissue (5, 21). Animal studies suggest that more estradiol fatty acid esters are formed when high concentrations of estrogens are present in the organism (22). In line with this, we have reported elevated serum concentrations of estradiol esters in pregnancy (23). The aims of this study were to quantify the serum and adipose tissue estradiol esters in pregnant and nonpregnant fertile-aged women as well as in postmenopausal women.
| Materials and Methods |
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Instruments and related reagents for time-resolved fluoroimmunoassay (TR-FIA) were purchased from Wallac Oy, Turku, Finland (PerkinElmer). Fluorescence was measured with the VICTOR 1420 multilabel counter with software 1.0. White goat antirabbit IgG-coated microtitration strips, DELFIA Platewash, DELFIA Plateshake, and DELFIA wash solution were used for immunoassay procedures, and dissociation-enhanced lanthanide fluoroimmunoassay (DELFIA) enhancement solution to develop the fluorescence. Radioactivity was determined with the Rackbeta liquid scintillation counter.
Methanol, hexane, ethyl acetate (HPLC grade), and diethyl ether (glass distilled grade) were from Rathburn Chemicals Ltd. (Walkerburn, Scotland, UK), and chloroform (Uvasol) was from Merck KgaA (Darmstadt, Germany). The assay buffer, Tris-HCl (pH 7.8), consisted of Tris 50 mmol/liter, 8.78 g NaCl, 0.5 g sodium azide, 5 g BSA (Sigma Chemical Co., St. Louis, MO), and 100 µg/liter Tween 40 up to 1000 ml of sterilized water. OptiPhase HiSafe2 scintillation fluid was from Wallac Oy.
Control samples and internal standard
3H-labeled estradiol-3,17ß-dioleate was used as an internal standard in each sample for determining the recovery. It was synthesized from 3H-labeled 17ß-estradiol (New England Nuclear Life Science Products, Inc., Waltham, MA) as described previously (23). Before each assay, the standard was purified by Sephadex LH-20 chromatography on the same or previous day. Estradiol-17ß-stearate (Steraloids, Inc., Newport, RI) added to a male serum pool (Finnish Red Cross) was used to prepare control samples. In each assay, two different concentrations of control estradiol-17ß-stearate in serum as well as distilled water were processed identically to the samples. The calibrators for TR-FIA were prepared from nonradioactive 17ß-estradiol (Steraloids, Inc.) by serial dilutions of stock solution (in methanol) in the assay buffer [11.5–1836 pmol/liter (3.13–500 ng/liter)].
Tissue samples
The visceral and sc adipose tissue, and blood were obtained from pregnant women undergoing cesarean section (n = 13), or nonpregnant, premenopausal women (n = 8) as well as postmenopausal women (n = 6) undergoing gynecological surgery for nonmalignant conditions. Subjects receiving any hormonal therapy were excluded from the study. Blood was centrifuged within 1 h. The serum and tissues were stored in –20 C or –80 C until analyzed. The study was approved by the Ethics Committee of the Department of Gynecology and Obstetrics in Helsinki University. All volunteering subjects gave their informed signed consent.
Analytical procedures (Fig. 1
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The protocol followed was a modification from the validated quantitative method for 17ß-estradiol fatty acid esters (23) summarized as follows.
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The thawed adipose tissue samples were weighed (100–300 mg) and rinsed with 1 ml sterile saline. The samples were then transferred into disposable glass tubes and homogenized (Ultra Turrax T8 Ika-Werke) in 1 ml distilled water. Internal standard, 3H-labeled estradiol-17ß-dioleate (3000–4000 dpm in 5 µl methanol per sample), was pipetted into disposable glass tubes (Fig. 1
) with 1000 µl serum (patient samples), 500 µl control serum samples, or homogenized adipose tissue samples. The serum samples were extracted four times with 2.5 volumes and tissue homogenates 3.5 volumes of diethyl ether-ethyl acetate (1:1, vol/vol) by mixing for 3 min. The organic phase was collected and evaporated under nitrogen until dry.
Isolation of esterified estradiol
Sephadex LH-20 chromatography was performed using 5-cm columns in disposable Pasteur pipettes (Pharmacia Biotech, Uppsala, Sweden) using hexane-chloroform (1:1, vol/vol). The samples were dissolved in 300 µl hexane-chloroform (1:1, vol/vol) and applied to the columns. The sample tubes were further washed twice with 300 µl hexane-chloroform, which was added to the columns. The estradiol esters were eluted with 6 ml hexane-chloroform. The nonesterified estradiol was then eluted with 5 ml methanol. The estradiol ester-containing fraction was evaporated to dryness under nitrogen. The nonesterified estradiol was stored at 4 C until analysis.
Hydrolysis and purification of the esters
The estradiol ester-containing fraction was hydrolyzed at 60 C for 2 h in 1 ml (adipose tissue) or 500 µl (serum) 1-mol/liter potassium hydroxide in methanol. To neutralize the samples, 1 ml (500 µl) distilled water and 280 µl (140 µl) 4 mol/liter HCl were added. The organic phase was removed by evaporation, and samples were then extracted twice with 3 ml diethyl ether, after which the organic phase was evaporated to dryness under nitrogen. The samples were dissolved in 300 µl hexane-chloroform (1:1, vol/vol) and subjected to another chromatography on Sephadex LH-20. After the addition of the samples to the columns, the sample tubes were further washed twice with 300 µl hexane-chloroform, which was added to the columns. Lipophilic impurities were eluted with 6 ml hexane-chloroform. The free estradiol produced by alkaline hydrolysis was eluted with 5 ml methanol and evaporated to dryness under nitrogen.
TR-FIA
Samples were dissolved in the assay buffer (0.5% BSA Tris). At low concentrations the samples were concentrated 3- to 2-fold to give better precision, i.e. values located on the linear part of the standard curve. At high concentrations the ester fractions were diluted 2-fold and the free estradiol fractions up to 200-fold. The recovery was determined by liquid scintillation counting. The protocol for the commercial TR-FIA reagent set was followed in our assay except that the estradiol antiserum and europium tracer were 50% more diluted.
The results were corrected for the recovery based on the internal standard, and for the dilution factor, if appropriate. The mean recovery for all serum samples was 64%, and for the adipose tissue 66%.
| Results |
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| Discussion |
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Clearly, the estradiol fatty acid esters are more abundant than free estradiol in the adipose tissue of nonpregnant women. The pathways for fatty acid esterification of estradiol as well as other steroid hormones have been observed in different organisms ranging from invertebrates, including insects, to vertebrates. Therefore, it is intriguing that the physiological role for endogenous steroid fatty acid esters is not clear. Based on the potent and long-lasting hormonal activity of these derivatives, it has been hypothesized that they form a reservoir of estrogen to be released for use in the target tissues, in situations characterized by estrogen depletion (1). This theory is supported by the relative abundance of esterified estradiol in comparison to levels of free estradiol in postmenopausal womens adipose tissue, as shown by our results.
There is some in vitro evidence that estradiol fatty acid esters protect LDL particles from oxidation at physiologically relevant concentrations (25), and LDL associated estradiol fatty acid esters can be delivered in human macrophages, protecting them against oxidation (26). However, it is not clear how important the antioxidative effects are in vivo, and whether the reduced serum esterified and nonesterified estradiol concentrations contribute to cardiovascular or other diseases on postmenopausal women. Furthermore, some data from rat studies seem to show that estrogen esters are important in stimulating cell growth in the fat-rich mammary tissue, whereas in uterus the endometrial free estradiol is more effective in this respect (22). Studies in invertebrates under conditions of excess estradiol suggest that esterification with fatty acids by activated estradiol acyltransferase could serve as a homeostatic mechanism to maintain stable endogenous free estradiol levels (27).
The exact mechanisms of the endogenous formation of estradiol fatty acid esters are not fully known. In blood, estradiol fatty acid esters synthesized by LCAT circulate associated with lipoprotein particles, especially with high-density lipoprotein (12). It has been proposed that estradiol esters are formed in situ in various tissues by specific acyltransferases (1, 16, 17). In rats, one microsomal enzyme may be responsible for estradiol, as well as testosterone and
5–3ß-hydroxy steroid (pregnenolone and dehydroepiandrosterone) fatty acid esterification (4). An acylcoenzyme A-estradiol-17ß acyltransferase has been implicated in studies in a variety of animal species (3, 16, 28, 29), but the enzymatic systems operating in humans remain to be characterized.
In adipose tissue, estrogen has direct effects on lipogenesis by decreasing the activity of lipoprotein lipase, and also has indirect effects on lipolysis, like inducing the hormone-sensitive lipase (HSL) (30). Interestingly, steroid fatty acid ester hydrolysis is regulated by HSL (31), which also regulates triglyceride hydrolysis in adipose tissue. The lipolytic activity of HSL is inhibited by insulin, and diminished HSL activity has been reported in various conditions characterized by insulin resistance and elevated serum levels of insulin (32). Accordingly, the regeneration of biologically active estradiol and other steroids by de-esterification may be linked to various metabolic states that regulate adipose tissue lipolysis. Estrogens, as well as other steroid hormones, also control the adipose tissue distribution, most likely via specific differences in the expression of steroid hormone receptors in various tissue deposits (20, 30). Human adipocytes from males and females express both ERs
and ß, and estrogen effects may be mediated by ER
in adipose tissue (30). Esterified estradiol does not bind to ERs (11), and variation in esterification capacity could, in theory, have effects on the adipose tissue deposition.
In conclusion, estradiol esterification with fatty acids is relatively low during estrogen excess associated with pregnancy but increases with lower levels of circulating estradiol. In the postmenopause the overwhelming majority of estradiol is present in adipose tissue, mostly in the form of fatty acid esters. In contrast, serum esterified and free estradiol concentrations are low, suggesting that the effects of estradiol produced in adipose tissue are not systemic but local.
| Acknowledgments |
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| Footnotes |
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Disclosure Statement: M.B., V.V., and A.T. have nothing to declare. T.S.M. reports consulting fees or paid advisory board and lecture fees from a commercial sponsor. M.J.T. reports consulting fees or advisory board (Merck, Pfizer) and lecture fees (Pfizer).
First Published Online August 28, 2007
Abbreviations: ER, Estrogen receptor; HSL, hormone-sensitive lipase; LCAT, lecithin-cholesterol acyltransferase; LDL, low-density lipoprotein; TR-FIA, time-resolved fluoroimmunoassay.
Received June 20, 2007.
Accepted August 20, 2007.
| References |
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and ß in human adipose tissue: influences of adipose cell differentiation and fat depot localization. Mol Cell Endocrinol 182:27–37[CrossRef][Medline]
5–3 ß-hydroxy steroid acyl transferase activities in tissues of the male rat and sheep. Steroids 62:422–426[CrossRef][Medline]This article has been cited by other articles:
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F. Wang, W. Wang, K. Wahala, H. Adlercreutz, E. Ikonen, and M. J. Tikkanen Role of lysosomal acid lipase in the intracellular metabolism of LDL-transported dehydroepiandrosterone-fatty acyl esters Am J Physiol Endocrinol Metab, December 1, 2008; 295(6): E1455 - E1461. [Abstract] [Full Text] [PDF] |
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