Póka R, Vad S, Lakos G, Bereczki Z, Kiss E, Sipka S
Department of Obstetrics and Gynecology, University of Debrecen, Medical and Health Science Cente, Nagyerdei krt.98, 4012 Debrecen, Hungary.
Contraception. 2004 Jan;69(1):27-30. doi: 10.1016/j.contraception.2003.08.016.
The risk of thromboembolism during oral contraceptive (OC) use is increased among factor V Leiden (FVL) carriers compared to women with wild-type genotype of the gene for coagulation factor V (FV). The carrier frequency in the general population is too high for FVL alone to be responsible for the reported association. Additional risk factors may be required to explain the increased risk of thromboembolism of carriers during OC use. We conducted a case-control study to compare the titer of anti-beta2-glycoprotein I immunoglobulin G (IgG) and the frequency of elevated titer of IgG type anti-beta2-glycoprotein I antibody between FVL carriers and individuals with FV wild-type genotype with and without pill use. An asymptomatic population of 313 unrelated nonpregnant women were screened for FVL and for the presence of anti-beta2-glycoprotein I IgG antibody. Sixty-six women were FVL carriers and 247 had normal genotype. One-hundred and thirty-five women used OC at the time of screening and 178 did not. Among FVL carriers, OC pill users had a higher mean anti-beta2-glycoprotein I IgG titer than nonusers (9.2 SGU/mL vs. 4.7 SGU/mL, p = 0.0485). Among women with FV wild-type genotype, there was no significant difference in anti-beta2-glycoprotein I IgG titers between users and nonusers of OCs (6.4 SGU/mL and 6.0 SGU/mL, respectively; p = 0.7010). The odds of an elevated anti-beta2-glycoprotein I IgG titer during OC use in FVL heterozygous women was 2.41 (95% confidence interval: 0.79-7.39) relative to users with-type genotype. FVL may contribute to the development of elevated titer of IgG type anti-beta2-glycoprotein I antibody during OC use. The elevated titer of IgG type anti-beta2-glycoprotein I antibody may select women among FVL carriers during OC use with an increased risk of thromboembolism.
与具有凝血因子V（FV）基因野生型基因型的女性相比，携带因子V莱顿（FVL）的女性在使用口服避孕药（OC）期间发生血栓栓塞的风险增加。在一般人群中，FVL的携带频率过高，仅FVL不足以解释所报道的关联。可能需要其他危险因素来解释携带者在使用OC期间血栓栓塞风险增加的原因。我们进行了一项病例对照研究，以比较FVL携带者与具有FV野生型基因型且使用或未使用避孕药的个体之间抗β2糖蛋白I免疫球蛋白G（IgG）的滴度以及IgG型抗β2糖蛋白I抗体滴度升高的频率。对313名无亲缘关系的非孕妇无症状人群进行了FVL和抗β2糖蛋白I IgG抗体检测。66名女性为FVL携带者，247名基因型正常。135名女性在筛查时使用OC，178名未使用。在FVL携带者中，使用OC的女性抗β2糖蛋白I IgG平均滴度高于未使用者（9.2 SGU/mL对4.7 SGU/mL，p = 0.0485）。在具有FV野生型基因型的女性中，使用和未使用OC的女性抗β2糖蛋白I IgG滴度无显著差异（分别为6.4 SGU/mL和6.0 SGU/mL；p = 0.7010）。与野生型基因型使用者相比，FVL杂合女性在使用OC期间抗β2糖蛋白I IgG滴度升高的比值为2.41（95%置信区间：0.79 - 7.39）。FVL可能在使用OC期间导致IgG型抗β糖蛋白I抗体滴度升高。IgG型抗β2糖蛋白I抗体滴度升高可能在使用OC期间的FVL携带者中筛选出血栓栓塞风险增加的女性。
