Wahl P, Walden C, Knopp R, Hoover J, Wallace R, Heiss G, Rifkind B
N Engl J Med. 1983 Apr 14;308(15):862-7. doi: 10.1056/NEJM198304143081502.
We studied 374 women taking oral contraceptives, 284 women taking estrogen preparations after menopause, and 1086 women taking no hormones, to determine the relation of plasma lipids and lipoprotein cholesterol concentrations to various types of estrogen/progestin formulations. Premenopausal women, using oral contraceptives containing a relatively low dose of estrogen combined with a medium or high dose of progestin (Norlestrin, Ovral, or Demulen) had a 24 per cent higher median concentration of low-density-lipoprotein cholesterol than did those not using hormones (P less than 0.05). Women using oral contraceptives that are high in estrogen and low in progestin (Enovid or Oracon) had significantly higher concentrations of high-density-lipoprotein cholesterol than did nonusers; those using Ovral, a low-estrogen and high-progestin formulation, had significantly lower levels of high-density-lipoprotein cholesterol. In postmenopausal women the use of estrogen was associated with concentrations of low-density-lipoprotein cholesterol that were 11 to 19 per cent below the levels in postmenopausal women who did not use hormones. The effects of estrogen-progestin balance on low-density and high-density lipoproteins may underlie the increased incidence of stroke and myocardial infarction in women of childbearing age who take oral contraceptives.
我们研究了374名服用口服避孕药的女性、284名绝经后服用雌激素制剂的女性以及1086名未服用激素的女性，以确定血浆脂质和脂蛋白胆固醇浓度与各种类型雌激素/孕激素制剂之间的关系。绝经前女性服用含相对低剂量雌激素与中或高剂量孕激素组合的口服避孕药（诺雷得、奥维拉、或德美伦），其低密度脂蛋白胆固醇的中位数浓度比未服用激素的女性高24%（P小于0.05）。服用高雌激素、低孕激素口服避孕药（复方炔雌醇片或奥拉克）的女性，其高密度脂蛋白胆固醇浓度显著高于未使用者；而服用低雌激素、高孕激素制剂奥维拉的女性，其高密度脂蛋白胆固醇水平显著较低。在绝经后女性中，使用雌激素与低密度脂蛋白胆固醇浓度比未使用激素的绝经后女性低11%至19%有关。雌激素 - 孕激素平衡对低密度和高密度脂蛋白的影响可能是服用口服避孕药的育龄女性中风和心肌梗死发病率增加的原因。
