Increased apolipoprotein AI production rate and redistribution of high-density lipoprotein size induced by estrogen plus progestin as oral contraceptive.
BACKGROUND
The impact of estrogen plus progestin as an oral contraceptive on high density lipoprotein (HDL) apolipoprotein (apo) AI metabolism in humans is poorly understood.


OBJECTIVE
This study was designed to measure the in vivo effect of Moneva (30 microg ethinylestradiol, 75 microg gestodene) on HDL apoAI production rate and fractional catabolic rate.


METHODS
Using (13)C-leucine, we performed two kinetic studies in the fed state in 10 normolipidemic young women, before and 3 months after beginning Moneva.


RESULTS
On Moneva, serum triglycerides increased by 12% (P = 0.03) in the fed state, whereas low-density lipoprotein and HDL cholesterol remained unchanged. HDL apoAI pool size and production rate were increased by 9.2% (67.3 +/- 7.1 vs. 61.6 +/- 6.7 mg x kg(-1); P = 0.05) and 26.5% (14.3 +/- 2.7 vs. 11.3 +/- 2.2 mg x kg(-1) x d(-1); P = 0.02), respectively. HDL apoAI fractional catabolic rate was not significantly modified. Three-month treatment by Moneva induced a shift of HDL size distribution from HDL2 toward HDL3 (HDL3 = 51.5 +/- 8.1 vs. 46.5 +/- 9.2% of total HDL; P = 0.02) and an increase in the proportion of apoAI among HDL components (38.8 +/- 4.3 vs. 34.4 +/- 2.8%; P = 0.01).


CONCLUSIONS
Oral contraception by estrogen plus progestin induces changes in HDL apoAI metabolism characterized by an increase in production rate and pool size, with a higher proportion of HDL3 particles. Whether or not these changes are beneficial to prevent atherosclerosis has to be explored further.
Duvillard
Laurence
L
Institut National de la Santé et de la Recherche Médicale Unité 866-Université de Bourgogne, Faculté de Médecine, Dijon F-21000, France. laurence.duvillard@chu-dijon.fr
Dautin
Guillaume
G
Florentin
Emmanuel
E
Jeannin
Aline
A
Pais de Barros
Jean-Paul
JP
Lagrost
Laurent
L
Petit
Jean-Michel
JM
Gambert
Philippe
P
Vergès
Bruno
B
D000328:Adult; D016632:Apolipoprotein A-I / Q000096:biosynthesis*; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects*; D003280:Contraceptives, Oral, Synthetic / Q000009:adverse effects*; D004997:Ethinyl Estradiol / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007700:Kinetics; D008055:Lipids / Q000097:blood; D008075:Lipoproteins, HDL / Q000097:blood*; D015233:Models, Statistical; D009652:Norpregnenes / Q000009:adverse effects*; D055815:Young Adult
D016632:Apolipoprotein A-I; D003278:Contraceptives, Oral, Hormonal; D003280:Contraceptives, Oral, Synthetic; D008055:Lipids; D008075:Lipoproteins, HDL; D009652:Norpregnenes; C033273:Gestodene; D004997:Ethinyl Estradiol