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低剂量口服避孕药后的脂质及生化变化

Lipid and biochemical changes after low-dose oral contraception.

作者信息

Loke D F, Ng C S, Holck S, Hall P E, Ratnam S S

机构信息

Department of Obstetrics and Gynecology, National University Hospital, National University of Singapore.

出版信息

Contraception. 1992 Sep;46(3):227-41. doi: 10.1016/0010-7824(92)90004-d.

Abstract

A randomized double-blind study of the metabolic effects of 2 low-dose combined oral contraceptives was carried out in Singaporean women. The subjects comprised 58 women randomly allocated to two treatment groups (29 each): norethisterone 1 mg/ethinyl estradiol 35 micrograms (NET/EE) or levonorgestrel 150 micrograms/ethinyl estradiol 30 micrograms (LNG/EE) and a control group of 23 women using intra-uterine devices (IUD). Blood samples were taken on admission and at 3 and 12 months after pills or insertion of IUDs. Fasting glucose levels were decreased while 2h glucose and triglyceride were increased throughout the treatment period in NET/EE group [corrected]. LNG/EE group only showed significant increase of 2h glucose at 12 months and decrease of LDL cholesterol at 3 months while total cholesterol was significantly suppressed at 3 and 12 months [corrected]. The atherogenic index, LDL/HDL cholesterol was significantly reduced by 12 months. Both groups had no change in hemoglobin, hematocrit and total protein levels but alkaline phosphatase, bilirubin and aspartate transaminase (SGOT) were suppressed. While NET/EE suppressed albumin significantly, this was not observed with LNG/EE group. However, these differences observed with use of each pill preparations, were not so obvious between treatment groups and control. Changes in total, HDL and LDL cholesterol and SGOT were not significantly different than the IUD group. Furthermore, except for 2h glucose, there was no increase in the number of abnormal parameters after treatment. On the contrary, there was a reduction of abnormal values in most liver function parameters. Thus, except for glucose intolerance, the observed changes in metabolic parameters may not constitute any clinical significance.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在新加坡女性中开展了一项关于两种低剂量复方口服避孕药代谢效应的随机双盲研究。研究对象包括58名女性,她们被随机分为两个治疗组(每组29人):炔诺酮1毫克/炔雌醇35微克(NET/EE)组或左炔诺孕酮150微克/炔雌醇30微克(LNG/EE)组,以及一个由23名使用宫内节育器(IUD)的女性组成的对照组。在入院时以及服用避孕药或放置宫内节育器后的3个月和12个月采集血样。在整个治疗期间,NET/EE组空腹血糖水平降低,而2小时血糖和甘油三酯升高[校正后]。LNG/EE组仅在12个月时2小时血糖显著升高,3个月时低密度脂蛋白胆固醇降低,而总胆固醇在3个月和12个月时显著降低[校正后]。致动脉粥样硬化指数,即低密度脂蛋白/高密度脂蛋白胆固醇在12个月时显著降低。两组的血红蛋白、血细胞比容和总蛋白水平均无变化,但碱性磷酸酶、胆红素和天冬氨酸转氨酶(SGOT)受到抑制。虽然NET/EE组显著抑制白蛋白,但LNG/EE组未观察到这种情况。然而,使用每种避孕药制剂观察到的这些差异在治疗组和对照组之间并不那么明显。总胆固醇、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇以及SGOT的变化与宫内节育器组无显著差异。此外,除2小时血糖外,治疗后异常参数数量没有增加。相反,大多数肝功能参数的异常值有所减少。因此,除了葡萄糖不耐受外,观察到的代谢参数变化可能不具有任何临床意义。(摘要截选至250字)

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