Samsioe G, Skryten A, Silfverstolpe G
Gynecol Obstet Invest. 1983;15(5):275-82. doi: 10.1159/000299421.
All commercially available combined oral contraceptives have 17-C-alkylated estrogens (ethinylestradiol or mestranol) as their estrogen components. In postmenopausal replacement therapy nonalkylated 'natural' estrogens have been shown to induce less adverse effects in lipid metabolism than alkylated estrogens. To see if this difference is valid also when the respective kinds of estrogens are used as components in oral contraceptives, the lipid metabolic effects from two preparations with the same progestogen component (norethisterone acetate) but with nonalkylated (17 beta-estradiol; Netagen) and alkylated (ethinylestradiol) estrogen (Netasyn) have been evaluated. Phospholipids, cholesterol, and triglycerides have been assessed in serum and in ultracentrifugally isolated lipoprotein fractions. The serum lecithin fatty acid composition has been analysed by gas-liquid chromatography. Netasyn increased the triglyceride content of serum and all lipoprotein fractions while Netagen did not. Netasyn caused a redistribution in the 1-position fatty acids of serum lecithin with an increase in palmitic and a concomitant decrease in stearic acid, a pattern associated with the 17-C-alkylation of a steroid and probably its capacity to inhibit liver excretory function. In the present study the preparation with the non-alkylated estrogen component had less adverse lipid metabolic effects than the conventional oral contraceptive.
所有市售的复方口服避孕药都含有17-C-烷基化雌激素（炔雌醇或炔诺酮）作为其雌激素成分。在绝经后替代疗法中，已证明非烷基化的“天然”雌激素在脂质代谢方面比烷基化雌激素引起的不良反应更少。为了探究当各自种类的雌激素用作口服避孕药的成分时这种差异是否也成立，对两种制剂的脂质代谢作用进行了评估，这两种制剂具有相同的孕激素成分（醋酸炔诺酮），但分别含有非烷基化雌激素（17β-雌二醇；Netagen）和烷基化雌激素（炔雌醇）（Netasyn）。对血清和超速离心分离的脂蛋白组分中的磷脂、胆固醇和甘油三酯进行了评估。通过气液色谱法分析了血清卵磷脂脂肪酸组成。Netasyn增加了血清和所有脂蛋白组分中的甘油三酯含量，而Netagen没有。Netasyn导致血清卵磷脂1位脂肪酸重新分布，棕榈酸增加，硬脂酸相应减少，这种模式与类固醇的17-C-烷基化及其可能抑制肝脏排泄功能的能力有关。在本研究中，含有非烷基化雌激素成分的制剂比传统口服避孕药具有更少的不良脂质代谢作用。
