Hyperhomocyst(e)inemia, anti-estrogen antibodies and other risk factors for thrombosis in women on oral contraceptives.
Hyperhomocyst(e)inemia was shown to be associated with vascular occlusion in atherosclerotic patients. We have conducted a study to determine if hyperhomocyst(e)inemia was also related to the vascular events observed in women on oral contraceptives, presumably having little or no atherosclerosis. Two hundred women receiving oral contraceptives were included in the study: 100 were healthy controls and 100 had documented vascular occlusion. Determination of serum homocyst(e)ine and anti-estrogen antibody levels wore performed under blind conditions. They were evaluated in logistic regression models in which age and smoking were also included. Women with vascular occlusion had higher levels of homocyst(e)ine (P less than 0.001) and of anti-estrogen antibodies (P less than 0.001) when compared to controls. They were also older (P less than 0.001) and more frequently smokers (P less than 0.05). The above mentioned variables were, in isolation, independent predictors of vascular occlusion. Moreover, a model assessing those variables and their interactions indicated that the levels of anti-estrogen antibodies and smoking increased the predictability in older women, as well as the levels of age-adjusted homocyst(e)ine. The study suggests that the above factors can identify women at risk and that determination of anti-estrogen antibodies and homocyst(e)ine levels may help to detect women predisposed to vascular occlusions when taking oral contraceptives.
Beaumont
V
V
Department of Cardiology, Hopital Henri Mondor, Creteil, France.
Malinow
M R
MR
Sexton
G
G
Wilson
D
D
Lemort
N
N
Upson
B
B
Beaumont
J L
JL
D000328:Adult; D000906:Antibodies / Q000032:analysis*; D003276:Contraceptives, Oral / Q000009:adverse effects*; D004997:Ethinyl Estradiol / Q000276:immunology*; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013927:Thrombosis / Q000209:etiology*
D000906:Antibodies; D003276:Contraceptives, Oral; D006710:Homocysteine; D004997:Ethinyl Estradiol