A randomized crossover comparison of two low-dose contraceptives: effects on serum lipids and lipoproteins.
The effect of a triphasic combination of ethinyl estradiol and levonorgestrel upon various lipoprotein parameters was compared to that of a preparation that contained ethinyl estradiol and desogestrel on days 6, 11, 21, and 28 of a control cycle, the third cycle of treatment with either ethinyl estradiol/levonorgestrel or ethinyl estradiol/desogestrel (11 volunteers each), the third cycle of a 3-month washout period, and the third treatment cycle after crossover change of the preparations. Significant increases were found in total triglycerides (15% to 20%) and phospholipids (8%) with both preparations, whereas total cholesterol and lipoprotein Lp(a) were not altered. High-density lipoprotein triglycerides (50% to 60%) and high-density lipoprotein-3 cholesterol (10% to 15%) were elevated by both contraceptives, high-density lipoprotein cholesterol and alpha-lipoprotein cholesterol only by ethinyl estradiol/desogestrel (11%), whereas high-density lipoprotein phospholipids, high-density lipoprotein-2 phospholipids, high-density lipoprotein-3 phospholipids, and high-density lipoprotein-2 cholesterol were not influenced. Both ethinyl estradiol/levonorgestrel and ethinyl estradiol/desogestrel increased apolipoproteins A (14%), A-I (20% to 30%), and A-II (25% to 35%) significantly. Very low-density lipoprotein triglycerides were elevated (30%) only by ethinyl estradiol/desogestrel, and low-density lipoprotein phospholipids (20%) by both ethinyl estradiol/levonorgestrel and ethinyl estradiol/desogestrel, whereas the other parameters, very low-density lipoprotein phospholipids, very low-density lipoprotein cholesterol, pre-beta-lipoprotein cholesterol, low-density lipoprotein triglycerides, low-density lipoprotein cholesterol, beta-lipoprotein cholesterol, and apolipoprotein B, were not significantly changed. Provided that the assumption is correct that high low-density lipoprotein cholesterol and apolipoprotein B and low high-density lipoprotein subfractions and apolipoprotein A are associated with an elevated risk of atherosclerosis, the results seem to represent beneficial rather than deleterious side effects of the low-dose oral contraceptives.
März
W
W
Gross
W
W
Gahn
G
G
Romberg
G
G
Taubert
H D
HD
Kuhl
H
H
D000328:Adult; D001054:Apolipoproteins A / Q000097:blood; D001055:Apolipoproteins B / Q000097:blood; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003277:Contraceptives, Oral, Combined / Q000494:pharmacology*; D017135:Desogestrel; D004997:Ethinyl Estradiol / Q000494:pharmacology*; D005260:Female; D006801:Humans; D016912:Levonorgestrel; D008055:Lipids / Q000097:blood*; D008074:Lipoproteins / Q000097:blood*; D008075:Lipoproteins, HDL / Q000097:blood; D008079:Lipoproteins, VLDL / Q000097:blood; D009644:Norgestrel / Q000494:pharmacology*; D009652:Norpregnenes / Q000494:pharmacology*; D010743:Phospholipids / Q000097:blood; D011897:Random Allocation; D014280:Triglycerides / Q000097:blood
D001054:Apolipoproteins A; D001055:Apolipoproteins B; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D003277:Contraceptives, Oral, Combined; D008055:Lipids; D008074:Lipoproteins; D008075:Lipoproteins, HDL; D008079:Lipoproteins, VLDL; D009652:Norpregnenes; D010743:Phospholipids; D014280:Triglycerides; D009644:Norgestrel; D004997:Ethinyl Estradiol; D016912:Levonorgestrel; D017135:Desogestrel; D002784:Cholesterol