Department of Obstetrics and Gynecology, Los Angeles, CA 90033, USA.
Contraception. 2012 Dec;86(6):739-45. doi: 10.1016/j.contraception.2012.05.148. Epub 2012 Sep 7.
The effects of subcutaneous depo-medroxyprogesterone acetate (DMPA-SC) injection on androgenic markers in obese women have not previously been studied.
Five normal-weight [body mass index (BMI)=18.5-24.9 kg/m²], five obese (BMI=30-39.9 kg/m²) and five extremely obese (BMI≥40 kg/m²) women were recruited for this prospective experimental study in which 104 mg DMPA-SC was administered at baseline and 12 weeks later. Serum levels of total testosterone (T), androstenedione (A), dehydroepiandrosterone sulfate (DHEAS), 3α-androstanediol glucuronide and sex hormone-binding globulin (SHBG) were quantified by immunoassay methods at baseline and at 13 and 26 weeks following the first injection; free T was calculated.
At baseline, obese women had lower levels of A and SHBG and higher total and free T levels than normal-weight women. There were a statistically significant decrease in the levels from baseline to week 26 among all three BMI classes for A, total T and SHBG (p≤.03) and an increase from baseline to week 26 in weight (p=.02). In addition, there was a statistically significant decrease in DHEAS from baseline to week 13 among all three BMI classes (p=.01), which was not sustained at week 26 (p>.1). Overall, the three groups responded similarly to all changes at week 13, and there were no statistically significant differences between groups at any time point (p≥.06).
DMPA-SC use in normal-weight, obese and extremely obese women can decrease serum androgen markers.
皮下注射的去甲孕素(DMPA-SC)对肥胖女性雄激素标志物的影响尚未得到研究。
本前瞻性实验研究纳入了 5 名正常体重(BMI=18.5-24.9kg/m²)、5 名肥胖(BMI=30-39.9kg/m²)和 5 名极度肥胖(BMI≥40kg/m²)女性,这些女性在基线时和 12 周后接受了 104mg 的 DMPA-SC 注射。在基线时和首次注射后 13 和 26 周,采用免疫分析方法检测总睾酮(T)、雄烯二酮(A)、硫酸脱氢表雄酮(DHEAS)、3α-雄烷二醇葡萄糖醛酸和性激素结合球蛋白(SHBG)的血清水平;游离 T 通过计算得出。
基线时,肥胖女性的 A 和 SHBG 水平较低,总 T 和游离 T 水平较高。与正常体重女性相比,所有三个 BMI 组的 A、总 T 和 SHBG 水平从基线到 26 周均呈统计学显著下降(p≤.03),体重从基线到 26 周呈上升趋势(p=.02)。此外,所有三个 BMI 组的 DHEAS 水平从基线到 13 周呈统计学显著下降(p=.01),但在 26 周时并未持续(p>.1)。总体而言,三组在第 13 周时对所有变化的反应相似,且在任何时间点均无组间统计学差异(p≥.06)。
在正常体重、肥胖和极度肥胖女性中使用 DMPA-SC 可降低血清雄激素标志物。