Effect on lipid metabolism of a biphasic desogestrel-containing oral contraceptive: divergent changes in apolipoprotein B and E and transitory decrease in Lp(a) levels.
The effect of a low dose biphasic oral contraceptive containing 40 micrograms ethinylestradiol + 25 micrograms desogestrel (7 tablets) and 30 micrograms ethinylestradiol + 125 micrograms desogestrel (15 tablets) on lipid metabolism was investigated in 19 women during 6 cycles of treatment and compared to the values of the pre- and post-treatment cycle. During treatment, all components of HDL increased reversibly by 10 to 30%. The levels of total cholesterol (CH), LDL-CH and IDL-CH rose only slightly, while those of total triglycerides (TG), VLDL-TG and LDL-TG rose continuously by more than 100% until the 6th cycle. At the same time, plasma levels of VLDL-CH increased by 60% and of apolipoprotein B by 20%. Contrary to this, apolipoprotein E decreased by 25% during treatment, and Lp(a) was transitorily reduced during the 3rd cycle. After termination of intake, total CH, LDL-CH, IDL-CH and apolipoprotein B remained elevated, while total TG, VLDL-TG, VLDL-CH and LDL-TG decreased significantly, but were still elevated during the post-treatment cycle. The levels of apolipoprotein E returned to pre-treatment values. The results indicate a marked preponderance of the effect of the estrogen component. The rise in TG and VLDL synthesis seems to be outweighed by an enhanced removal of apolipoprotein E-containing remnants which might offer protection from the development of atherosclerosis.
Kuhl
H
H
Department of Obstetrics and Gynecology, J.W. Goethe University, Frankfurt am Main, Germany.
März
W
W
Jung-Hoffmann
C
C
Weber
J
J
Siekmeier
R
R
Gross
W
W
D000328:Adult; D001055:Apolipoproteins B / Q000097:blood*; D001057:Apolipoproteins E / Q000097:blood*; D002784:Cholesterol / Q000097:blood; D003279:Contraceptives, Oral, Sequential / Q000494:pharmacology*; D017135:Desogestrel / Q000494:pharmacology*; D004997:Ethinyl Estradiol / Q000494:pharmacology; D005260:Female; D006801:Humans; D050356:Lipid Metabolism; D017270:Lipoprotein(a) / Q000097:blood*; D014280:Triglycerides / Q000097:blood
D001055:Apolipoproteins B; D001057:Apolipoproteins E; D003279:Contraceptives, Oral, Sequential; D017270:Lipoprotein(a); D014280:Triglycerides; D004997:Ethinyl Estradiol; D017135:Desogestrel; D002784:Cholesterol