title: Effect of low-dose oral contraceptives on metabolic risk factors in African-American women.
abstract: BACKGROUND
  The effect of oral contraceptive pill (OCP) use on cardiovascular risk in African-American women is unknown.
  
  
  OBJECTIVE
  Our objective was to examine in African-American women the effect of OCP use on insulin resistance, glucose intolerance, and triglycerides (TGs).
  
  
  METHODS
  This was a cross-sectional study.
  
  
  METHODS
  The study was conducted at the National Institutes of Health Clinical Research Center.
  
  
  METHODS
  A total of 104 healthy nondiabetic African-American women [21 OCP users, 83 controls, age mean +/- sd, 34.7 +/- 7.6 yr, body mass index (BMI) 31 +/- 8.4 kg/m(2)] was included in the study.
  
  
  METHODS
  Subjects had oral glucose tolerance tests, insulin-modified frequently sampled iv glucose tolerance tests, and fasting lipid profiles. Insulin resistance was determined by the insulin sensitivity index (S(I)).
  
  
  METHODS
  Insulin resistance, glucose tolerance status, and TG levels were determined.
  
  
  RESULTS
  Fasting glucose did not differ between OCP users and controls (P = 0.27). In contrast, compared with controls, 2-h glucose (135 +/- 23 vs.120 +/- 25 mg/dl; P = 0.01) and fasting TGs (73 +/- 31 vs.57 +/- 27 mg/dl; P = 0.02) were higher in OCP users. OCP users tended to be more insulin resistant than controls (S(I): 2.51 +/- 2.01 vs. 3.46 +/- 2.09; P = 0.09). Multiple regression analysis revealed that BMI, age, and OCP use were significant determinants of 2-h glucose (adjusted R(2) = 0.37; P < 0.001) and TG levels (adjusted R(2) = 0.21; P < 0.001). As BMI was a determinant of both 2-h glucose and TGs, participants were divided into nonobese and obese groups, and the analyses repeated. Among the nonobese women, the OCP users were more insulin resistant (S(I): 2.91 +/- 1.58 vs. 4.35 +/- 1.88; P = 0.03) and had a higher prevalence of glucose intolerance than controls (odds ratio 5.7; 95% confidence interval 1.4-24; P = 0.01).
  
  
  CONCLUSIONS
  In African-American women, OCP use is associated with an increase in markers of cardiovascular risk manifested by increased insulin resistance, glucose intolerance, and elevated TGs.
authors.affiliation: Clinical Endocrinology Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892, USA.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Frempong
authors.forename: Madia
authors.initials: M
authors.lastname: Ricks
authors.forename: Sabyasachi
authors.initials: S
authors.lastname: Sen
authors.forename: Anne E
authors.initials: AE
authors.lastname: Sumner
mesh_terms: D000328:Adult; D001741:Black or African American; D002318:Cardiovascular Diseases / Q000209:etiology; D016022:Case-Control Studies; D003276:Contraceptives, Oral / Q000009:adverse effects / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D018149:Glucose Intolerance / Q000209:etiology; D006728:Hormones / Q000097:blood; D006801:Humans; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D024821:Metabolic Syndrome / Q000097:blood / Q000209:etiology*; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications; D012307:Risk Factors
chemical_list: D003276:Contraceptives, Oral; D006728:Hormones; D008055:Lipids