Department of Pharmacology, King Abdul-Aziz University, Jeddah, Saudi Arabia.
Synapse Research Institute, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands.
PLoS One. 2018 Oct 25;13(10):e0206376. doi: 10.1371/journal.pone.0206376. eCollection 2018.
The effect of oral contraceptive (OC) usage on coagulation has been studied worldwide. However, no such studies have been conducted in Saudi Arabia on Saudi women using OCs. The aim of this study was to investigate the effects of OC-induced changes of thrombin generation (TG) in the absence and presence of activated protein C (APC) or thrombomodulin (TM) in Saudi women.
A total of 115 adult women, 47 on oral contraception (OC users) and 68 controls (not using OCs) were recruited from the obstetrics-gynecology outpatient clinic in Saudi Arabia. OCs that were used in this study include the following: Marvelon, Gynera, Cerrazetem, Yasmine, Microlut, Gracial and Diane. The plasma calibrated automated thrombinography (CAT) was used to determine TG which was expressed as endogenous thrombin potential (ETP; nM/min), lag time (min), peak (nM) and time-to-peak (ttpeak; min). In the presence of TM or APC, TG parameters were expressed relative to the parameters in the absence of TM or APC.
As in other populations, our study demonstrated that OC usage induced prothrombotic changes in plasma of Saudi women, including resistance to the inhibitory actions of TM and APC. More specifically, OC usage in our population predominantly influenced TG and APC/TM sensitivity in overweight and obese individuals, a finding that needs confirmation in large cohort studies. The effects of APC and TM on TG parameters showed a positive association, and the correlation coefficients were higher in OC users for both ETP and peak values.
口服避孕药（OC）的使用对凝血的影响已在全球范围内进行了研究。然而，沙特阿拉伯尚未对使用 OC 的沙特女性进行过此类研究。本研究旨在探讨 OC 诱导的凝血酶生成（TG）变化在缺乏和存在激活蛋白 C（APC）或血栓调节蛋白（TM）的情况下对沙特女性的影响。
共招募了 115 名成年女性，47 名服用口服避孕药（OC 使用者）和 68 名对照（未使用 OC），来自沙特阿拉伯的妇产科门诊。本研究中使用的 OC 包括 Marvelon、Gynera、Cerrazetem、Yasmine、Microlut、Gracial 和 Diane。使用校准自动凝血酶生成（CAT）测定 TG，以表示内源性凝血酶潜能（ETP；nM/min）、滞后时间（min）、峰值（nM）和达峰时间（ttpeak；min）。在存在 TM 或 APC 的情况下，TG 参数相对于不存在 TM 或 APC 的参数进行表达。
与其他人群一样，我们的研究表明，OC 使用导致沙特女性血浆中促血栓形成变化，包括对 TM 和 APC 的抑制作用产生抵抗。更具体地说，在我们的人群中，OC 使用主要影响超重和肥胖个体的 TG 和 APC/TM 敏感性，这一发现需要在大型队列研究中得到证实。APC 和 TM 对 TG 参数的影响呈正相关，且 OC 使用者的 ETP 和峰值的相关系数更高。
