Quintino-Moro Alessandra, Zantut-Wittmann Denise Engelbrecht, Silva Dos Santos Priscilla de Nazaré, Melhado-Kimura Vaneska, da Silva Conceição Aparecida, Bahamondes Luis, Fernandes Arlete
a Family Planning Clinic, Department of Obstetrics and Gynecology , University of Campinas Medical School (UNICAMP) , Campinas , Brazil.
b Division of Endocrinology, Department of Internal Medicine , University of Campinas Medical School (UNICAMP) , Campinas , Brazil.
Eur J Contracept Reprod Health Care. 2019 Apr;24(2):102-108. doi: 10.1080/13625187.2018.1559284. Epub 2019 Feb 5.
The aim of the study was to evaluate thyroid function profile as a possible factor influencing weight and body composition variation in new users of depot medroxyprogesterone acetate (DMPA).
A prospective, non-randomised, comparative study was conducted at the University of Campinas, Brazil. Women aged 18-40 years with a body mass index (BMI) less than 30 kg/m, normal oral glucose tolerance test, no known diseases, and using no medication, who opted to use DMPA were paired by age (±1 year) and BMI (±1 kg/m) with women initiating copper intrauterine device (IUD) use. The main outcome measures were thyroid function profile, weight, and body composition, as measured by dual-energy X-ray absorptiometry. We used repeated measures ANOVA to perform comparisons between times and groups.
We evaluated 28 DMPA users and 24 IUD users who completed the 12-month follow-up. We observed that FT4 levels were higher at 12 months (compared to baseline) in the DMPA group (p < .0001) and that FT4/FT3 ratio had increased in both groups. Additionally, at 12 months, total body mass had increased around 2 kg and lean mass increased in the DMPA group compared to the IUD group; there was also an increase in weight, BMI, total body mass, and fat mass when compared to baseline.
No changes in thyroid function occurred that could explain the weight increase observed in DMPA users.
本研究旨在评估甲状腺功能指标，作为影响醋酸甲羟孕酮长效避孕针（DMPA）新使用者体重和身体成分变化的一个可能因素。
在巴西坎皮纳斯大学进行了一项前瞻性、非随机、对照研究。选择年龄在18 - 40岁、体重指数（BMI）小于30 kg/m²、口服葡萄糖耐量试验正常、无已知疾病且未服用药物的女性，她们选择使用DMPA，并按年龄（±1岁）和BMI（±1 kg/m²）与开始使用铜宫内节育器（IUD）的女性配对。主要观察指标为甲状腺功能指标、体重和身体成分，通过双能X线吸收法测量。我们使用重复测量方差分析进行时间和组间比较。
我们评估了28名使用DMPA和24名使用IUD并完成12个月随访的使用者。我们观察到，DMPA组在12个月时（与基线相比）FT4水平更高（p <.0001），且两组的FT4/FT3比值均升高。此外，在12个月时，与IUD组相比，DMPA组的总体重增加了约2 kg，瘦体重增加；与基线相比，体重、BMI、总体重和脂肪量也有所增加。
甲状腺功能没有发生变化，无法解释DMPA使用者体重增加的现象。
