Gaspard U J, Buret J, Gillain D, Romus M A, Lambotte R
Contraception. 1985 Apr;31(4):395-408. doi: 10.1016/0010-7824(85)90006-x.
Changes in serum lipid and lipoprotein levels were evaluated in a randomized prospective study conducted in matched healthy young women before and after 6 months' use of three oral contraceptives (OCs): Trigynon (preparation A, n = 13), a triphasic OC containing low doses of ethinylestradiol (EE) and levonorgestrel (LNG); Marvelon (preparation B, n = 14), a monophasic OC containing low doses of EE + Desogestrel (DOG, a new progestogen derived from LNG); and Ovidol (preparation C, n = 11), a sequential OC containing higher doses (50 micrograms) of EE + DOG. After 6 months of use, total triglyceride levels were non-significantly increased by preparations A (+ 29% from basal values) and B (+21%), and very significantly increased by preparation C (+90%). Total cholesterol and phospholipids were unchanged by preparations A and B, whereas phospholipids were significantly increased by preparation C. However, HDL-cholesterol, LDL-cholesterol and their epidemiologically important ratios (HDL-chol:total-chol; LDL-chol:HDL-chol) were kept unchanged by all preparations tested. Apolipoprotein A-1 (Apo A-1) was slightly but significantly increased by all three preparations whereas apolipoprotein B (Apo B) was significantly decreased by preparation B. All ratios Apo A-1:Apo B were accordingly ("favorably") increased, especially during treatment with preparation B. In conclusion, the triphasic OC containing low doses of LNG does not induce obvious, clinically significant, alterations of lipid metabolism, and it is also the case for the low-dose monophasic combination of EE + DOG. The higher-dose sequential preparation of EE + DOG behaves as a more estrogenic compound, increasing total triglyceride concentrations above the normal range.
在一项随机前瞻性研究中，对匹配的健康年轻女性在使用三种口服避孕药（OCs）6个月前后的血清脂质和脂蛋白水平变化进行了评估：Trigynon（制剂A，n = 13），一种含有低剂量炔雌醇（EE）和左炔诺孕酮（LNG）的三相OC；Marvelon（制剂B，n = 14），一种含有低剂量EE + 去氧孕烯（DOG，一种源自LNG的新型孕激素）的单相OC；以及Ovidol（制剂C，n = 11），一种含有较高剂量（50微克）EE + DOG的序贯OC。使用6个月后，制剂A（比基础值增加29%）和B（增加21%）使总甘油三酯水平无显著升高，而制剂C使其非常显著升高（增加90%）。制剂A和B使总胆固醇和磷脂保持不变，而制剂C使磷脂显著增加。然而，所有测试制剂均使高密度脂蛋白胆固醇（HDL-胆固醇）、低密度脂蛋白胆固醇及其在流行病学上重要的比率（HDL-胆固醇：总胆固醇；低密度脂蛋白胆固醇：HDL-胆固醇）保持不变。三种制剂均使载脂蛋白A-1（Apo A-1）略有但显著增加，而制剂B使载脂蛋白B（Apo B）显著降低。相应地，所有Apo A-1：Apo B比率均升高（“有利地”），尤其是在使用制剂B治疗期间。总之，含有低剂量LNG的三相OC不会引起脂质代谢的明显、临床上显著的改变，含有低剂量EE + DOG的单相组合也是如此。较高剂量的EE + DOG序贯制剂表现为一种雌激素作用更强的化合物，使总甘油三酯浓度升高至正常范围以上。
