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低剂量去氧孕烯-炔雌醇复方治疗多囊卵巢综合征女性的脂质代谢研究

Lipid metabolic studies in women with a polycystic ovary syndrome during treatment with a low-dose desogestrel-ethinylestradiol combination.

作者信息

Cullberg G, Hamberger L, Mattsson L A, Mobacken H, Samsioe G

出版信息

Acta Obstet Gynecol Scand. 1985;64(3):203-7. doi: 10.3109/00016348509155113.

DOI:10.3109/00016348509155113
PMID:3160212
Abstract

Twenty women with the polycystic ovary syndrome (PCO) were treated with a combination of desogestrel and ethinylestradiol (EE) and the effects on lipids and lipoproteins were compared with those induced in a group of 13 regularly menstruating, healthy women. All women were examined before and after 3 months of treatment. Compared with the regularly menstruating women, the PCO women had significantly higher body weights and blood pressure as well as elevated levels of triglycerides in serum and VLDL. During treatment, 14 out of 20 women affected by PCO lost weight. No significant change in blood pressure was observed. In the PCO group, moderate increments were encountered in serum cholesterol, phospholipids and triglycerides. No significant changes were seen in LDL-cholesterol or HDL-cholesterol. The ratio LDL-cholesterol/HDL-cholesterol did not alter. The level of total cholesterol in VLDL rose during treatment. These changes in serum and lipoprotein lipids in PCO patients were of the same type and magnitude as those found in the control group, apart from an increase in HDL-cholesterol in the latter. The only remaining difference after treatment was a slightly higher level of VLDL triglycerides in the PCO women. Thus only moderate changes were induced in lipid and lipoprotein patterns by the combination of desogestrel and EE. A "positive" influence on lipids and lipoproteins cannot be considered as a further advantage, added to the list of indications when hormonal treatment is used in PCO-affected women. The clinical implications of elevated triglycerides remain to be clarified.

摘要

20名患有多囊卵巢综合征(PCO)的女性接受了去氧孕烯和炔雌醇(EE)联合治疗,并将其对脂质和脂蛋白的影响与一组13名月经规律的健康女性所产生的影响进行了比较。所有女性在治疗3个月前后均接受了检查。与月经规律的女性相比,PCO女性的体重、血压明显更高,血清甘油三酯和极低密度脂蛋白(VLDL)水平也有所升高。治疗期间,20名受PCO影响的女性中有14人体重减轻。未观察到血压有显著变化。在PCO组中,血清胆固醇、磷脂和甘油三酯出现了适度升高。低密度脂蛋白胆固醇(LDL - cholesterol)或高密度脂蛋白胆固醇(HDL - cholesterol)未见显著变化。LDL - cholesterol/HDL - cholesterol比值未改变。治疗期间VLDL中的总胆固醇水平升高。PCO患者血清和脂蛋白脂质的这些变化与对照组中发现的变化类型和程度相同,只是对照组中HDL - cholesterol有所增加。治疗后唯一剩下的差异是PCO女性的VLDL甘油三酯水平略高。因此,去氧孕烯和EE联合治疗仅引起脂质和脂蛋白模式的适度变化。对于受PCO影响的女性使用激素治疗时,不能将对脂质和脂蛋白的“积极”影响视为除现有适应证之外的进一步优势。甘油三酯升高的临床意义仍有待阐明。

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