Department of Kinesiology, Pennsylvania State University, University Park, PA, United States.
Division of Pediatric Endocrinology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
Front Endocrinol (Lausanne). 2020 Jun 16;11:334. doi: 10.3389/fendo.2020.00334. eCollection 2020.
Combined hormonal contraceptive therapy has been associated with negative bone mineral density outcomes that may be route-dependent [i.e., combined oral contraception (COC) vs. contraceptive vaginal ring (CVR)] and involve the hepatic growth hormone (GH)/insulin-like growth factor-I (IGF-I) axis. The objective of the pilot study was to assess the impact of route of contraceptive administration on IGF-I and procollagen type I N-terminal propeptide (PINP) responses to an IGF-I Generation Test. We hypothesized that the peak rise in IGF-I and PINP concentration and area under the curve (AUC) would be attenuated following COC, but not CVR, use. Healthy, premenopausal women not taking hormonal contraception were recruited. Women were enrolled in the control group ( = 8) or randomly assigned to COC ( = 8) or CVR ( = 8) for two contraceptive cycles. IGF-I Generation Tests were used as a probe to stimulate IGF-I release and were completed during the pre-intervention and intervention phases. Serum IGF-I and PINP were measured during both IGF-I Generation Tests. The study was registered at ClinicalTrials.gov (NCT02367833). Compared to the pre-intervention phase, peak IGF-I concentration in response to the IGF-I Generation Test in the intervention phase was suppressed in the COC group ( < 0.001), but not the CVR or Control groups ( > 0.090). Additionally, compared to the pre-intervention phase, PINP AUC during the intervention phase was suppressed in both COC and CVR groups ( < 0.001), while no difference was observed in the control group ( = 0.980). These data suggest that changes in recombinant human GH-stimulated hepatic IGF-I synthesis in response to combined hormonal contraception (CHC) use are dependent on route of CHC administration, while the influence on PINP is route-independent. Future research is needed to expand these results with larger randomized control trials in all age ranges of women who utilize hormonal contraception. www.ClinicalTrials.gov registration NCT02367833.
联合激素避孕疗法与骨密度降低有关，这种影响可能与途径有关[即口服避孕药（COC）与避孕阴道环（CVR）]，并涉及肝生长激素（GH）/胰岛素样生长因子-I（IGF-I）轴。该初步研究的目的是评估避孕途径对 IGF-I 和前胶原 I N 端前肽（PINP）对 IGF-I 生成试验反应的影响。我们假设，COC 使用后 IGF-I 和 PINP 浓度和曲线下面积（AUC）的峰值升高将减弱，但 CVR 不会。我们招募了未服用激素避孕药的健康绝经前妇女。将女性纳入对照组（n=8）或随机分为 COC 组（n=8）或 CVR 组（n=8）进行两个避孕周期。IGF-I 生成试验被用作刺激 IGF-I 释放的探针，并在干预前和干预阶段完成。在两次 IGF-I 生成试验期间均测量血清 IGF-I 和 PINP。该研究在 ClinicalTrials.gov 注册（NCT02367833）。与干预前阶段相比，COC 组在干预阶段 IGF-I 生成试验中 IGF-I 浓度的峰值降低（<0.001），但 CVR 组或对照组则没有（>0.090）。此外，与干预前阶段相比，COC 组和 CVR 组在干预阶段期间的 PINP AUC 均受到抑制（<0.001），而对照组则没有差异（=0.980）。这些数据表明，对联合激素避孕（CHC）使用的反应中，重组人 GH 刺激的肝 IGF-I 合成的变化取决于 CHC 的给药途径，而对 PINP 的影响则与途径无关。需要进一步的研究，以在所有使用激素避孕的女性年龄范围内，用更大的随机对照试验来扩展这些结果。ClinicalTrials.gov 注册号 NCT02367833。
