Oral contraceptives and lipids and lipoproteins: Part II--Relationship to plasma steroid levels and outlier status.
A randomized clinical trial of oral contraceptives evaluated 67 women on 50 ug ethinyl estradiol (EE) and 1.0 mg norethindrone (NE), 61 women on 35 ug EE and 1.0 mg NE, and 64 women on 35 ug EE and 0.5 mg NE. At baseline, three, six and nine months, lipids and lipoproteins were measured as well as selected plasma determinations of the contraceptive steroids. Data was related to change in outlier status for lipids/lipoproteins (less than 10th percentile for high-density lipoprotein cholesterol and apolipoprotein A-1, greater than 90th percentile for all others). Women on the lowest dose preparation had the smallest trend towards outlier status for high-density lipoprotein cholesterol and apolipoprotein A-1. An increase over the time period of the study in the initial slope (one hour level minus zero hour level over time) of NE and a decrease in the initial slope of EE was associated with a shift to outlier status for low-density lipoprotein cholesterol. A number of other relationships were also shown. Use of the techniques described might assist in identifying sub-groups of women at risk for adverse cardiovascular sequelae associated with oral contraceptive use.
Burkman
R T
RT
Department of Gynecology-Obstetrics, Henry Ford Hospital, Detroit, Michigan 48202.
Zacur
H A
HA
Kimball
A W
AW
Kwiterovich
P
P
Bell
W R
WR
D000293:Adolescent; D000328:Adult; D003277:Contraceptives, Oral, Combined / Q000494:pharmacology*; D004305:Dose-Response Relationship, Drug; D004997:Ethinyl Estradiol / Q000097:blood* / Q000494:pharmacology; D005260:Female; D006801:Humans; D050356:Lipid Metabolism; D008074:Lipoproteins / Q000378:metabolism*; D009640:Norethindrone / Q000097:blood* / Q000494:pharmacology; D016032:Randomized Controlled Trials as Topic
D003277:Contraceptives, Oral, Combined; D008074:Lipoproteins; D004997:Ethinyl Estradiol; D009640:Norethindrone