第三代口服避孕药对年轻女性高敏C反应蛋白和同型半胱氨酸的影响。

Effects of third-generation oral contraceptives on high-sensitivity C-reactive protein and homocysteine in young women.

作者信息

Cauci Sabina, Di Santolo Manuela, Culhane Jennifer F, Stel Giuliana, Gonano Fabio, Guaschino Secondo

机构信息

Department of Biomedical Sciences and Technologies, School of Medicine, University of Udine, Udine, Italy.

出版信息

Obstet Gynecol. 2008 Apr;111(4):857-64. doi: 10.1097/AOG.0b013e31816a2476.

DOI:10.1097/AOG.0b013e31816a2476

PMID:18378744

Abstract

OBJECTIVE

To evaluate the effect of third-generation oral contraceptives on high-sensitivity C-reactive protein (CRP), homocysteine, and lipids levels in a population of young, fertile, nonobese women.

METHODS

Blood markers were evaluated in 277 healthy white women (mean age 23 years and mean body-mass index 21 kg/m(2)). Seventy-seven oral contraceptive users were compared with 200 non-oral contraceptive users. Progressive cutoffs of high-sensitivity CRP and homocysteine levels were examined.

RESULTS

Levels of high-sensitivity CRP posing a high risk of cardiovascular disease (3.0 to less than 10.0 mg/L) were found in 27.3% of oral contraceptive users and in 8.5% of non-oral contraceptive users (odds ratio 4.04; 95% confidence interval [CI] 1.99-8.18). Levels of high-sensitivity CRP at intermediate risk (1.0 to less than 3.0 mg/L) were found in 32.5% of oral contraceptive users and in 11.0% of non-oral contraceptive users (odds ratio 3.89; 95% CI 2.03-7.46). Notably, non-oral contraceptive users were 8.65 (95% CI 4.39-17.1) times as likely to demonstrate a protective level of high-sensitivity CRP (less than 0.5 mg/L) compared with oral contraceptive users. Oral contraceptive use increased serum triglycerides (P<.001) and total cholesterol P=.001); however, high-density lipoprotein, not low-density lipoprotein, contributed to this increase. A decreased ratio of low-density lipoprotein to high-density lipoprotein cholesterol was observed in oral contraceptive users compared with nonusers (P=.016). Oral contraceptive use did not affect homocysteine levels.

CONCLUSION

Third-generation oral contraceptive use increases low-grade inflammatory status measured by high-sensitivity CRP concentrations. Alteration of inflammatory status in oral contraceptive users could affect the risk of venous thromboembolism, cardiovascular disease, and other oral contraceptive-associated adverse conditions in young women.

摘要

目的

评估第三代口服避孕药对年轻、有生育能力、非肥胖女性群体中高敏C反应蛋白（CRP）、同型半胱氨酸和血脂水平的影响。

方法

对277名健康白人女性（平均年龄23岁，平均体重指数21kg/m²）的血液标志物进行评估。将77名口服避孕药使用者与200名非口服避孕药使用者进行比较。检查高敏CRP和同型半胱氨酸水平的逐步临界值。

结果

在口服避孕药使用者中，27.3%的人高敏CRP水平处于心血管疾病高风险（3.0至小于10.0mg/L），在非口服避孕药使用者中这一比例为8.5%（优势比4.04；95%置信区间[CI]1.99 - 8.18）。在口服避孕药使用者中，32.5%的人高敏CRP水平处于中度风险（1.0至小于3.0mg/L），在非口服避孕药使用者中这一比例为11.0%（优势比3.89；95%CI 2.03 - 7.46）。值得注意的是，与口服避孕药使用者相比，非口服避孕药使用者出现高敏CRP保护水平（小于0.5mg/L）的可能性是其8.65倍（95%CI 4.39 - 17.1）。使用口服避孕药会增加血清甘油三酯（P<0.001）和总胆固醇（P = 0.001）；然而，导致这种增加的是高密度脂蛋白，而非低密度脂蛋白。与非使用者相比，口服避孕药使用者的低密度脂蛋白与高密度脂蛋白胆固醇比值降低（P = 0.016）。使用口服避孕药不影响同型半胱氨酸水平。