Wynn V, Adams P W, Godsland I, Melrose J, Niththyananthan R, Oakley N W, Seed M
Lancet. 1979 May 19;1(8125):1045-9. doi: 10.1016/s0140-6736(79)92949-0.
Oral glucose-tolerance tests were performed and fasting serum cholesterol and triglyceride levels measured in 1628 Caucasian women taking combined oestrogen/progestagen oral contraceptives (o.c.) and 577 women not taking O.C. The former were divided into six groups according to the composition of the O.C Glucose tolerance deteriorated in all O.C. groups containing oestrane progestagens (nortestosterone-derived) or the gonane, norgestrel, but was unaltered by O.C. containing a pregnane progestagen (derived from progesterone). The greatest deterioration was with O.C. containing 75 microgram or more oestrogen, and this was associated with impairment of the early insulin response to glucose. In O.C. containing a pregnane progestagen insulin secretion was unaffected. In the remaining O.C. groups insulin secretion was increased; this was most pronounced with the O.C. containing a gonane progestagen. Serum-cholesterol was elevated only with O.C. containing 75 microgram or more oestrogen and an oestrane progestagen and tended to be lower in O.C. containing a gonane progestagen. O.C.-induced hypertriglyceridaemia was oestrogen-dose-related, and this effect was potentiated by the pregnane progestagen. The gonane progestagen antagonised oestrogen-induced hypertriglyceridaemia.
对1628名服用复方雌激素/孕激素口服避孕药（OC）的白人女性和577名未服用OC的女性进行了口服葡萄糖耐量试验，并测量了空腹血清胆固醇和甘油三酯水平。根据OC的成分，将前者分为六组。在所有含有孕甾烷类孕激素（源自孕酮）的OC组中，葡萄糖耐量没有改变，但在所有含有孕甾烯类孕激素（源自睾酮）或孕二烯酮（去甲睾酮衍生物）的OC组中，葡萄糖耐量均恶化。恶化最严重的是含有75微克或更多雌激素的OC，这与早期胰岛素对葡萄糖的反应受损有关。在含有孕甾烷类孕激素的OC中，胰岛素分泌未受影响。在其余的OC组中，胰岛素分泌增加；在含有孕二烯酮类孕激素的OC中，这种情况最为明显。仅在含有75微克或更多雌激素和孕甾烯类孕激素的OC中，血清胆固醇升高，而在含有孕二烯酮类孕激素的OC中，血清胆固醇往往较低。OC引起的高甘油三酯血症与雌激素剂量相关，孕甾烷类孕激素会增强这种作用。孕二烯酮类孕激素可对抗雌激素引起的高甘油三酯血症。
