Berga S L
University of Pittsburgh School of Medicine, Pennsylvania 15213, USA.
Am J Obstet Gynecol. 1998 Jul;179(1):S9-17. doi: 10.1016/s0002-9378(98)70291-1.
The purpose was to evaluate the metabolic effects of Mircette (brand of desogestrel/ethinyl estradiol and ethinyl estradiol), a low-estrogen, desogestrel-containing oral contraceptive.
Women taking Mircette were evaluated to determine its effects on lipid profiles (n = 74), carbohydrate metabolism (n = 25), and endocrine parameters (n = 53).
During cycles 3 and 6 of Mircette treatment, changes from baseline included mean increases in serum triglycerides and very low-density lipoprotein cholesterol ranging between 50% and 60%. Smaller mean increases were observed at these time points in high-density lipoprotein cholesterol subfraction 2 (range between 17% and 25%), total cholesterol (<10%), high-density lipoprotein cholesterol (range between 10% and 15%), and high-density lipoprotein cholesterol subfraction 3 (range between 9% and 13%), with only nominal changes (<6%) in low-density lipoprotein cholesterol and lipoprotein. Patients receiving Mircette showed no mean changes in fasting plasma glucose or serum insulin levels but did have modest increases in glucose and insulin levels after a glucose challenge. Mircette treatment suppressed follicle-stimulating hormone, luteinizing hormone, 17beta-estradiol, and progesterone to levels consistent with inhibition of ovulation and increased concentrations of thyroid- and cortisol-binding globulins.
Overall, Mircette treatment was associated with expected effects on the pituitary-ovarian axis, triglycerides, and serum binding proteins; a modest decline in glucose tolerance; and a favorable effect on lipid profiles as a result of increases in total high-density lipoprotein cholesterol and high-density lipoprotein cholesterol subfraction 2 in the absence of changes in total cholesterol or low-density lipoprotein cholesterol.
评估低雌激素、含去氧孕烯的口服避孕药米非司酮(去氧孕烯/炔雌醇和炔雌醇品牌)的代谢作用。
对服用米非司酮的女性进行评估,以确定其对血脂谱(n = 74)、碳水化合物代谢(n = 25)和内分泌参数(n = 53)的影响。
在米非司酮治疗的第3和第6周期,与基线相比的变化包括血清甘油三酯和极低密度脂蛋白胆固醇平均升高50%至60%。在这些时间点,高密度脂蛋白胆固醇亚组分2(升高幅度在17%至25%之间)、总胆固醇(<10%)、高密度脂蛋白胆固醇(升高幅度在10%至15%之间)和高密度脂蛋白胆固醇亚组分3(升高幅度在9%至13%之间)的平均升高幅度较小,低密度脂蛋白胆固醇和脂蛋白仅有微小变化(<6%)。接受米非司酮治疗的患者空腹血糖或血清胰岛素水平无平均变化,但在葡萄糖激发试验后血糖和胰岛素水平有适度升高。米非司酮治疗可抑制促卵泡激素、促黄体生成素、17β-雌二醇和孕酮至与抑制排卵一致的水平,并增加甲状腺素结合球蛋白和皮质醇结合球蛋白的浓度。
总体而言,米非司酮治疗对垂体-卵巢轴、甘油三酯和血清结合蛋白有预期作用;糖耐量有适度下降;由于总高密度脂蛋白胆固醇和高密度脂蛋白胆固醇亚组分2升高,而总胆固醇或低密度脂蛋白胆固醇无变化,对血脂谱有有利影响。