Department of Kinesiology and Health, Georgia State University, Atlanta, Georgia, USA.
Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa, USA.
Exp Physiol. 2023 Jan;108(1):5-11. doi: 10.1113/EP090861. Epub 2022 Nov 30.
What is the main observation in this case? The main observation of this case report is substantial improvement in cutaneous microvascular endothelial function after cessation of long-term use of a fourth-generation oral contraceptive pill. This improvement appears independent of relative changes in the contribution of nitric oxide. What insights does it reveal? Our findings suggest that cessation of long-term, fourth-generation oral contraceptive pill use improves endothelial function within 20 months of cessation.
The purpose of this case report was to evaluate in vivo endothelial function and nitric oxide (NO)-dependent vasodilatation before and after the cessation of long-term (11-12 years) fourth-generation oral contraceptive pill (OCP) use in one young, healthy and premenopausal woman. This retrospective analysis includes data from six experimental visits: three visits during months 133-144 of fourth-generation OCP use and three visits 19-22 months after OCP cessation. Endothelium-dependent and NO-dependent vasodilatation were assessed in the cutaneous microvasculature using laser-Doppler flowmetry, a rapid local heating protocol (39°C, 0.1°C/s) and pharmacological perfusion through intradermal microdialysis fibres. The participant had consistent medical history and lifestyle behaviours throughout both hormonal exposures. Data are presented as the mean (SD). Endothelium-dependent vasodilatation was 42 (10)% of site-specific maximal cutaneous vascular conductance (CVC ) during OCP use and 63 (10)%CVC after OCP cessation (49% increase). Nitric oxide-dependent vasodilatation was 70 (5)% contribution of NO during OCP use and 60 (15)%NO after OCP cessation (15% reduction). Baseline blood flow was greater after OCP cessation, but maximal blood flow was reduced. Data from this case report support a substantial increase in cutaneous microvascular endothelial function assessed via local heating after cessation of long-term use of a fourth-generation OCP, which does not appear to be attributable to increased NO bioavailability. Overall, these data suggest an improvement in endothelial and microvascular function after the cessation of long-term use of a fourth-generation OCP.
本病例的主要观察结果是什么？本病例报告的主要观察结果是，停止长期使用第四代口服避孕药后，皮肤微血管内皮功能有显著改善。这种改善似乎与一氧化氮贡献的相对变化无关。这揭示了哪些见解？我们的发现表明，停止长期使用第四代口服避孕药后，内皮功能在停药后 20 个月内得到改善。
本病例报告的目的是评估一名年轻、健康和绝经前女性在停止长期（11-12 年）第四代口服避孕药（OCP）使用前后，体内内皮功能和一氧化氮（NO）依赖性血管舒张的情况。这项回顾性分析包括 6 次实验访问的数据：在第四代 OCP 使用的 133-144 个月期间进行了 3 次访问，在 OCP 停止后 19-22 个月进行了 3 次访问。使用激光多普勒血流仪评估皮肤微循环中的内皮依赖性和 NO 依赖性血管舒张，采用快速局部加热方案（39°C，0.1°C/s）和通过皮内微透析纤维进行药理学灌注。参与者在两种激素暴露期间均有一致的病史和生活方式行为。数据表示为平均值（标准差）。在使用 OCP 期间，内皮依赖性血管舒张为特定部位最大皮肤血管传导率（CVC）的 42（10）%，在停止 OCP 后为 63（10）%CVC（增加 49%）。NO 依赖性血管舒张在使用 OCP 期间为 NO 的 70（5）%贡献，在停止 OCP 后为 60（15）%NO（减少 15%）。停止 OCP 后，基线血流增加，但最大血流减少。本病例报告的数据支持通过局部加热评估长期使用第四代 OCP 后皮肤微血管内皮功能的显著增加，这似乎与 NO 生物利用度的增加无关。总的来说，这些数据表明，停止长期使用第四代 OCP 后，内皮和微血管功能得到改善。
