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两种仅含去氧孕烯(75微克/天)或左炔诺孕酮(30微克/天)的孕激素避孕药对碳水化合物代谢以及肾上腺和甲状腺功能的影响。

The effects of two progrestogen-only pills containing either desogestrel (75 microgram/day) or levonorgestrel (30 microgram/day) on carbohydrate metabolism and adrenal and thyroid function.

作者信息

Kivelä A, Ruuskanen M, Agren U, Dieben T

机构信息

Lääkärikeskus Gyneko Oy, Finland.

出版信息

Eur J Contracept Reprod Health Care. 2001 Jun;6(2):71-7.

Abstract

OBJECTIVE

To compare the effects of two progestogen-only pills, containing either desogestrel or levonorgestrel, on carbohydrate metabolism, and adrenal and thyroid function.

METHODS

In a double-blind, randomized, multicenter study in Finland, 84 healthy female volunteers received either desogestrel 75 microg/day or levonorgestrel 30 microg/day for seven treatment periods of 28 days. The following laboratory parameters were measured at screening, and at treatment periods 3 and 7: carbohydrate metabolism (glucose, insulin, glycosylated hemoglobin (HbA1C)), adrenal function (total cortisol, cortisol binding globulin (CBG), dehydroepiandrosterone sulfate (DHEAS)), thyroid function (thyroid stimulating hormone, free thyroxine).

RESULTS

Overall, the effect on carbohydrate metabolism was minimal with both study medications. There was a trend for higher glucose and insulin values for the levonorgestrel group at both treatment periods 3 and 7. None of the changes were thought to be clinically relevant. Both preparations had similar small effects on HbA1C values, indicating that carbohydrate metabolism was not affected. No effects were found on thyroid function parameters or DHEAS in either treatment group; however, total cortisol and CBG were slightly higher with desogestrel than with levonorgestrel. These changes were not considered to be clinically relevant. Both treatments were well tolerated.

CONCLUSIONS

The effects of both progestogen-only pills on carbohydrate metabolism were minimal and considered to be clinically insignificant. With regard to adrenal and thyroid function, the effects of desogestrel were not significantly different from those of levonorgestrel.

摘要

目的

比较两种仅含去氧孕烯或左炔诺孕酮的孕激素避孕药对碳水化合物代谢、肾上腺及甲状腺功能的影响。

方法

在芬兰进行的一项双盲、随机、多中心研究中,84名健康女性志愿者接受了为期7个28天治疗周期的药物治疗,其中一组每天服用75微克去氧孕烯,另一组每天服用30微克左炔诺孕酮。在筛选时以及治疗周期3和7时测量了以下实验室参数:碳水化合物代谢(葡萄糖、胰岛素、糖化血红蛋白(HbA1C))、肾上腺功能(总皮质醇、皮质醇结合球蛋白(CBG)、硫酸脱氢表雄酮(DHEAS))、甲状腺功能(促甲状腺激素、游离甲状腺素)。

结果

总体而言,两种研究药物对碳水化合物代谢的影响均极小。在治疗周期3和7时,左炔诺孕酮组的葡萄糖和胰岛素值均有升高趋势。但这些变化均被认为无临床相关性。两种制剂对HbA1C值的影响相似,表明碳水化合物代谢未受影响。两个治疗组的甲状腺功能参数或DHEAS均未发现有影响;然而,去氧孕烯组的总皮质醇和CBG略高于左炔诺孕酮组。这些变化被认为无临床相关性。两种治疗的耐受性均良好。

结论

两种孕激素避孕药对碳水化合物代谢的影响极小,且被认为无临床意义。在肾上腺和甲状腺功能方面,去氧孕烯与左炔诺孕酮的影响无显著差异。

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