Greenlund K J, Webber L S, Srinivasan S, Wattigney W, Johnson C, Berenson G S
Tulane Center for Cardiovascular Health, Tulane School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA.
Ann Epidemiol. 1997 Nov;7(8):561-7. doi: 10.1016/s1047-2797(97)00119-1.
Cross-sectional and longitudinal associations of serum lipids and lipoproteins with oral contraceptive (OC) use were examined among white and black women aged 18-27 years in 1985-86 and 1988-1991 in the Bogalusa Heart Study, a study of cardiovascular disease in a Southern community.
Analyses of covariance.
In 1985-1986, white OC users had significantly (p < 0.05) higher adjusted mean total and low density lipoprotein (LDL) cholesterols, and lower high density lipoprotein (HDL) cholesterol compared with nonusers; black OC users had higher triglycerides and LDL cholesterol, and lower HDL cholesterol. In 1988-1991, white OC users had higher total cholesterol, triglycerides, and LDL cholesterol, while black OC users had higher triglycerides. OC use was unrelated to mean HDL cholesterol levels in 1988-1991; however, a lower percentage of white OC users than nonusers in 1988-1991 had HDL cholesterol levels < 35 mg/dl. Longitudinally, white OC nonusers at baseline who used OCs at follow-up had significant increases from baseline levels in total cholesterol, triglycerides, and very low density lipoprotein (VLDL) and LDL cholesterols; black women showed an increase only in LDL cholesterol. White women who stopped using OCs by follow-up had a decrease in VLDL and LDL cholesterols, and an increase in HDL cholesterol. White OC users at both exams also had a significant increase in HDL cholesterol, whereas women who began using OCs by follow-up did not.
The unfavorable lipid profile associated with OC use was not apparent upon discontinued use. Lack of an adverse effect of OC use on HDL cholesterol at follow-up may be the result of changing formulations, and requires further examination.
在博加卢萨心脏研究中，对1985 - 1986年和1988 - 1991年年龄在18 - 27岁的白人和黑人女性中血清脂质和脂蛋白与口服避孕药（OC）使用之间的横断面和纵向关联进行了研究，该研究是关于一个南方社区心血管疾病的研究。
协方差分析。
在1985 - 1986年，与未使用者相比，白人OC使用者经调整后的平均总胆固醇和低密度脂蛋白（LDL）胆固醇显著更高（p < 0.05），高密度脂蛋白（HDL）胆固醇更低；黑人OC使用者甘油三酯和LDL胆固醇更高，HDL胆固醇更低。在1988 - 1991年，白人OC使用者总胆固醇、甘油三酯和LDL胆固醇更高，而黑人OC使用者甘油三酯更高。1988 - 1991年，OC使用与平均HDL胆固醇水平无关；然而，1988 - 1991年HDL胆固醇水平< 35 mg/dl的白人OC使用者比例低于未使用者。纵向来看，基线时未使用OC且随访时使用OC的白人，其总胆固醇、甘油三酯、极低密度脂蛋白（VLDL）和LDL胆固醇较基线水平显著升高；黑人女性仅LDL胆固醇升高。随访时停止使用OC的白人女性VLDL和LDL胆固醇降低，HDL胆固醇升高。两次检查时均使用OC的白人女性HDL胆固醇也显著升高，而随访时开始使用OC的女性则没有。
与OC使用相关的不利脂质谱在停药后并不明显。随访时OC使用对HDL胆固醇缺乏不良影响可能是制剂变化的结果，需要进一步研究。
