Silfverstolpe G, Gustafson A, Samsioe G, Svanborg A
Acta Obstet Gynecol Scand Suppl. 1979;88:89-95. doi: 10.3109/00016347909157235.
Ten oophorectomized women (ranging in age from 27 to 45 years, having a mean age of 34.5 years with a standard deviation of 5.3) were given three different progestogens (norgestrel, norethisterone and medroxyprogesterone) in treatment periods of 3 weeks' duration immediately preceded by 3 weeks "wash out" periods. Venous blood samples were drawn before and after each treatment period. Free and total cholesterol, triglycerides and phospholipids were determined in the three lipoprotein fractions: Very low density lipoproteins (VLDL), low density lipoprotein (LDL) and high density lipoprotein (HDL). Individual phosphatides were determined after thin layer chromatography. In addition, the relative fatty acid composition of serum lecithin and cholesterol esters were assessed by gas-liquid-chromatography. Both norethisterone and norgestrel caused a decrease in alpha-lipoprotein cholesterol. The relative fatty acid composition of serum lecithin revealed an increase of biochemical pathway 1 for liver lecithin synthesis on norgestrel and norethisterone but no major changes on medroxyprogesterone. With norgestrel an increase in serum-lysolecithin concomitant with a decrease in lecithin was observed, while the two other progestogens did not induce any significant changes. From the present data it is suggested that the 19-norethisterone derivatives, norethisterone and especially norgestrel, have androgen-like influences on lipid metabolism. Medroxyprogesterone, being a 17-alpha-hydroxyprogesterone, caused less changes and consequently less disturbance of lipid metabolism.
十名接受卵巢切除术的女性（年龄在27至45岁之间，平均年龄为34.5岁，标准差为5.3）在为期3周的治疗期前先经过3周的“洗脱”期，然后分别接受三种不同的孕激素（炔诺孕酮、炔诺酮和甲羟孕酮）治疗。在每个治疗期前后采集静脉血样。测定极低密度脂蛋白（VLDL）、低密度脂蛋白（LDL）和高密度脂蛋白（HDL）这三种脂蛋白组分中的游离胆固醇和总胆固醇、甘油三酯及磷脂。薄层色谱后测定各磷脂。此外，通过气液色谱法评估血清卵磷脂和胆固醇酯的相对脂肪酸组成。炔诺酮和炔诺孕酮均导致α-脂蛋白胆固醇降低。血清卵磷脂的相对脂肪酸组成显示，炔诺孕酮和炔诺酮作用下肝脏卵磷脂合成的生化途径1增加，而甲羟孕酮作用下无重大变化。使用炔诺孕酮时，观察到血清溶血卵磷脂增加而卵磷脂减少，而其他两种孕激素未引起任何显著变化。根据目前的数据表明，19-去甲炔诺酮衍生物，即炔诺酮尤其是炔诺孕酮，对脂质代谢具有雄激素样影响。甲羟孕酮作为17-α-羟孕酮，引起的变化较少，因此对脂质代谢的干扰也较小。
