Department of Obstetrics and Gynecology, Division of Family Planning, Stanford University, Stanford, CA 94305, USA.
Contraception. 2013 Jul;88(1):177-82. doi: 10.1016/j.contraception.2012.10.029. Epub 2012 Dec 4.
Hormonal contraception is the most common medication used by reproductive aged women but there is little understanding of the impact of hormonal contraception on obesity and metabolism. Adipokine levels (adiponectin, resistin) and markers of adipocyte development (DLK-1) are altered in obese animals and humans and are associated with increased cardiovascular risk. We sought to determine the effect of combined hormonal oral contraceptive pills (COCs) on circulating adiponectin, resistin and DLK-1 levels in obese and normal-weight rhesus macaque monkeys.
Serum adiponectin, resistin and DLK-1 levels in reproductive-age female rhesus macaques of normal (n = 5, mean = 5.76 kg) and inherently obese (n = 5, mean = 8.11 kg) weight were determined before, during and 2 months after cessation of 8 months of continuous treatment with COCs.
The obese group alone showed a significant decrease (p<.01) in weight with COC use, which returned to baseline after COC cessation. Baseline adiponectin levels prior to COC treatment were lower in the obese group (p<.05). Adiponectin levels increased from baseline in both groups, but more so in the obese group (p<.05). Resistin levels were similar at baseline, with an increase in both groups following treatment. Circulating resistin remained elevated above baseline levels after COC cessation, particularly in the obese group (p<.05). While DLK-1 levels did not change significantly in either group, a trend for higher levels in obese animals was observed.
COC use may alter metabolic processes via direct (resistin) or indirect (adiponectin) means, while unchanging DLK1 levels suggest they do not affect adipocyte development. COCs may directly increase resistin levels, as observed in both groups. As adiponectin is inversely related to adipocyte mass, increased levels in the obese group are likely attributed to weight loss.
激素避孕是育龄妇女最常用的药物，但人们对激素避孕对肥胖和代谢的影响知之甚少。肥胖动物和人类的脂联素、抵抗素水平（adiponectin、resistin）和脂肪细胞发育标志物（DLK-1）发生改变，与心血管风险增加相关。我们旨在确定联合激素口服避孕药（COCs）对肥胖和正常体重恒河猴循环脂联素、抵抗素和 DLK-1 水平的影响。
测定 5 只正常体重（平均=5.76kg）和 5 只固有肥胖（平均=8.11kg）育龄雌性恒河猴使用 COC 前、使用中和停用 8 个月 COC 后 2 个月的血清脂联素、抵抗素和 DLK-1 水平。
仅肥胖组在使用 COC 时体重显著下降（p<.01），COC 停用后体重恢复基线。COC 治疗前肥胖组基础脂联素水平较低（p<.05）。两组基础脂联素水平均升高，但肥胖组升高更明显（p<.05）。两组治疗后抵抗素水平均升高。COC 停用后，两组的循环抵抗素仍高于基线水平，尤其是肥胖组（p<.05）。虽然两组的 DLK-1 水平均无显著变化，但肥胖动物的水平呈升高趋势。
COC 可能通过直接（抵抗素）或间接（脂联素）途径改变代谢过程，而不变的 DLK1 水平表明它们不影响脂肪细胞发育。正如观察到的两组都直接增加了抵抗素水平。由于脂联素与脂肪细胞质量呈负相关，肥胖组水平升高可能归因于体重减轻。
