Burkman R T, Robinson J C, Kruszon-Moran D, Kimball A W, Kwiterovich P, Burford R G
Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, Maryland.
Obstet Gynecol. 1988 Jan;71(1):33-8.
To determine the effects of oral contraceptives on lipids and lipoproteins over a six-month period, we randomized 266 women into four oral contraceptive groups: ethinyl estradiol 35 micrograms plus ethynodiol diacetate 1 mg, ethinyl estradiol 30 micrograms plus levonorgestrel 0.15 mg, ethinyl estradiol 35 micrograms plus norethindrone 1 mg, and ethinyl estradiol 35 micrograms plus norethindrone 0.5 and 1 mg (biphasic). For all groups, total cholesterol increased 5.9-9.1% from baseline values over the six months. Triglycerides increased with all preparations, with the ethynodiol diacetate group (37.6%) and the biphasic norethindrone group (45.3%) showing the greatest increase. Low-density lipoprotein cholesterol increased 10-15.6% among the groups; low-density lipoprotein-apolipoprotein B changed proportional to the low-density lipoprotein cholesterol increases. All groups except the ethynodiol diacetate group showed a decrease of high-density lipoprotein cholesterol, with the levonorgestrel group (8.7%) and biphasic norethindrone group (4.5%) showing the largest declines. Apolipoprotein A-1 increased in all groups, with the ethynodiol diacetate preparation (19.3%) showing the greatest increase and the levonorgestrel preparation (3.2%) showing the smallest increase from baseline values. The changes in apolipoprotein A-1 were out of proportion to the changes in high-density lipoprotein cholesterol, suggesting that the high-density lipoprotein particle may be undergoing some type of metabolic alteration.
为了确定口服避孕药在六个月期间对脂质和脂蛋白的影响，我们将266名女性随机分为四个口服避孕药组：炔雌醇35微克加双醋炔诺醇1毫克、炔雌醇30微克加左炔诺孕酮0.15毫克、炔雌醇35微克加炔诺酮1毫克，以及炔雌醇35微克加炔诺酮0.5毫克和1毫克（双相）。对于所有组，总胆固醇在六个月内较基线值增加了5.9 - 9.1%。所有制剂均使甘油三酯升高，双醋炔诺醇组（37.6%）和双相炔诺酮组（45.3%）升高幅度最大。各组低密度脂蛋白胆固醇升高了10 - 15.6%；低密度脂蛋白载脂蛋白B的变化与低密度脂蛋白胆固醇的升高成比例。除双醋炔诺醇组外，所有组的高密度脂蛋白胆固醇均下降，左炔诺孕酮组（8.7%）和双相炔诺酮组（4.5%）下降幅度最大。所有组的载脂蛋白A - 1均升高，双醋炔诺醇制剂（19.3%）较基线值升高幅度最大，左炔诺孕酮制剂（3.2%）升高幅度最小。载脂蛋白A - 1的变化与高密度脂蛋白胆固醇的变化不成比例，这表明高密度脂蛋白颗粒可能正在经历某种类型的代谢改变。
