Sex hormone--binding globulin--a surrogate marker for the prothrombotic effects of combined oral contraceptives.
OBJECTIVE
The purpose of this study was to investigate the plausibility of serum sex hormone-binding globulin (SHBG) concentration as a risk marker for venous thromboembolism (VTE) during use of combined oral contraceptives (COC). Study design This was a prospective, randomized cross-over study. Thirty-five women were treated with COCs containing the same amount of ethinyl estradiol and either levonorgestrel (LNG/EE) or desogestrel (DG/EE). Serum SHBG and markers of hemostasis were determined before and after 2 months on each treatment.


RESULTS
SHBG increased significantly with both preparations. Treatment with DG/EE caused more pronounced prothrombotic changes in hemostatic parameters than LNG/EE. With both treatment regimens, there was a significant correlation between changes in resistance to activated protein C (APCr) and changes in plasma SHBG.


CONCLUSIONS
The correlation between SHBG and the well-established risk factor APCr might indicate the usefulness of SHBG as a risk marker for VTE during COC treatment.
Department of Woman and Child Health, Division of Obstetrics and Gynecology, Karolinska Hospital, Stockholm, Sweden. marianne.vanrooijen@ks.se
M
M
van Rooijen
A
A
Silveira
A
A
Hamsten
K
K
Bremme
D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D003277:Contraceptives, Oral, Combined / Q000009:adverse effects*; D018592:Cross-Over Studies; D006801:Humans; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D011446:Prospective Studies; D011486:Protein C / Q000032:analysis; D018570:Risk Assessment; D012738:Sex Hormone-Binding Globulin / Q000032:analysis*; D020246:Venous Thrombosis / Q000097:blood / Q000139:chemically induced*
D015415:Biomarkers; D003277:Contraceptives, Oral, Combined; D017395:Plasminogen Activator Inhibitor 1; D011486:Protein C; D012738:Sex Hormone-Binding Globulin