Lipson A, Stoy D B, LaRosa J C, Muesing R A, Cleary P A, Miller V T, Gilbert P R, Stadel B
Contraception. 1986 Aug;34(2):121-34. doi: 10.1016/0010-7824(86)90065-x.
In order to determine the effects on plasma lipoproteins of oral contraceptives containing progestins with varying androgenic potency, 136 healthy women were randomized into 3 groups and followed prospectively for one year while receiving either 50 mcg ethinyl estradiol and 1.0 mg ethynodiol diacetate (EED), 50 mcg ethinyl estradiol and 1.0 mg norethindrone acetate (ENA), or 50 mcg ethinyl estradiol and 0.5 mg d-1 norgestrel (ENG). Comparison was made to a self-selected group of 50 women using alternative means of contraception. Plasma cholesterol increased by 7-9% and triglycerides by 32-57% in all 3 groups (p less than 0.05). ENG use resulted in other significant lipoprotein changes including an 18% increase in low density lipoprotein cholesterol (LDL-C), a 13% fall in high density lipoprotein cholesterol (HDL-C) and a 27% decline in HDL2 cholesterol (HDL2-C) (p less than 0.05). Apoprotein A-I (Apo A-I) increased by 9% with ENA and by 11% with EED (p less than 0.05), but did not change significantly with ENG. This prospective study demonstrates that in oral contraceptive agents with identical estrogen, progestins with different androgenic potency produce major and different changes in plasma lipoproteins.
为了确定含有不同雄激素活性孕激素的口服避孕药对血浆脂蛋白的影响，136名健康女性被随机分为3组，并在接受50微克炔雌醇和1.0毫克双醋炔诺醇（EED）、50微克炔雌醇和1.0毫克醋酸炔诺酮（ENA）或50微克炔雌醇和0.5毫克d-1左炔诺孕酮（ENG）的同时进行了为期一年的前瞻性随访。与一组自行选择使用其他避孕方法的50名女性进行了比较。所有3组的血浆胆固醇均升高了7-9%，甘油三酯升高了32-57%（p<0.05）。使用ENG还导致了其他显著的脂蛋白变化，包括低密度脂蛋白胆固醇（LDL-C）升高18%，高密度脂蛋白胆固醇（HDL-C）降低13%，HDL2胆固醇（HDL2-C）降低27%（p<0.05）。载脂蛋白A-I（Apo A-I）在使用ENA时升高了9%，在使用EED时升高了11%（p<0.05），但在使用ENG时没有显著变化。这项前瞻性研究表明，在雌激素相同的口服避孕药中，具有不同雄激素活性的孕激素会在血浆脂蛋白中产生重大且不同的变化。
