Friedl K E, Plymate S R, Paulsen C A
Contraception. 1985 Apr;31(4):409-20. doi: 10.1016/0010-7824(85)90007-1.
Serum lipids were examined in thirty normal male volunteers who had received depo-medroxyprogesterone acetate (DMPA) and testosterone cypionate (TC) in a male contraceptive trial. Progestagens have been implicated in the changes in serum lipids observed in women using oral contraceptives and this has led to concern about cardiovascular health risks associated with the long-term use of some of these preparations. The following study was done to determine if similar effects occur in men. The men in this study were divided into three DMPA dose groups (50, 100, 200 mg/month) and received intramuscular injections for six months; all men received 250 mg/month TC. There was no significant change in serum high density lipoprotein-cholesterol (HDL-C) levels during the six months of drug administration when compared to levels in the control period. However, there was a marked decrease in HDL-C during the first three months after discontinuation of the drugs (p less than 0.02). This observed change was consistent in each of the three DMPA dose groups but no dose relationship was observed. There was no statistically significant change in serum concentrations of total cholesterol, low density lipoprotein-cholesterol, triglycerides or insulin in any period of the experiment. Serum testosterone (T), estradiol, and sex hormone binding globulin (SHBG), luteinizing hormone (LH), and follicle stimulating hormone (FSH) concentrations were all significantly depressed during the drug administration period. A progestagen dose relationship was observed only for the decrease in serum testosterone and LH concentrations. Serum T and SHBG levels were still significantly reduced at 4-6 months after cessation of the drug administration. These findings demonstrate that DMPA can cause a reduction in serum HDL-C levels. It is suggested that HDL-C concentrations fell only following DMPA withdrawal as a consequence of steroid hormone changes specific to this period.
在一项男性避孕试验中，对30名接受醋酸甲羟孕酮（DMPA）和环戊丙酸睾酮（TC）的正常男性志愿者进行了血脂检测。孕激素与使用口服避孕药的女性所观察到的血脂变化有关，这引发了对长期使用其中一些制剂相关心血管健康风险的担忧。进行以下研究以确定男性是否会出现类似影响。本研究中的男性被分为三个DMPA剂量组（50、100、200毫克/月），并接受了六个月的肌肉注射；所有男性均接受250毫克/月的TC。与对照期水平相比，在药物给药的六个月期间，血清高密度脂蛋白胆固醇（HDL-C）水平没有显著变化。然而，在停药后的前三个月，HDL-C显著下降（p小于0.02）。在三个DMPA剂量组中，这种观察到的变化都是一致的，但未观察到剂量关系。在实验的任何阶段，血清总胆固醇、低密度脂蛋白胆固醇、甘油三酯或胰岛素的浓度均无统计学上的显著变化。在药物给药期间，血清睾酮（T）、雌二醇、性激素结合球蛋白（SHBG）、促黄体生成素（LH）和促卵泡生成素（FSH）的浓度均显著降低。仅在血清睾酮和LH浓度降低方面观察到孕激素剂量关系。在停药后4至6个月，血清T和SHBG水平仍显著降低。这些发现表明，DMPA可导致血清HDL-C水平降低。有人认为，HDL-C浓度仅在停用DMPA后下降，是这一时期特定的类固醇激素变化的结果。
