title: Combined Oral Contraceptives Increase High-Sensitivity C-Reactive Protein but Not Haptoglobin in Female Athletes.
abstract: BACKGROUND
  No studies have examined the effects of oral hormonal contraception on chronic low-grade inflammation as assessed by stratified levels of high-sensitivity C-reactive protein (hsCRP) in athletes. We explored the impact of combined oral contraceptives (OCs) on serum hsCRP, haptoglobin, triglycerides and cholesterol in white female athletes.
  
  
  METHODS
  Italian sportswomen (n = 205; mean age 24 ± 5.3 years; body mass index 21 ± 2.2 kg m-2; sport activity 8.7 ± 3.65 h week-1) were analyzed according to OC use.
  
  
  RESULTS
  Progressive hsCRP levels were evaluated in OC users (n = 53) compared to non-OC users (n = 152). Levels of hsCRP from 3.0 to <10.0 mg L-1(at high risk of future cardiovascular events) were found in 26.4 % (14/53) of OC users and only in 2.6 % (4/153) of non-OC users (OR = 13.3, 95 % CI 4.14-42.6, P < 0.001). Risky hsCRP levels ≥1.0 mg L-1were found in 62.3 % of OC users versus 13.2 % non-OC users (OR = 10.9, 95 % CI 5.26-22.5, P < 0.001). Protective hsCRP levels (<0.5 mg L-1) were found in 17.0 % of OC users and in 64.5 % of non-OC users (OR = 0.11, 95 % CI 0.05-0.25, P < 0.001). OC use increased serum triglycerides (P < 0.001), total cholesterol (P = 0.027) and HDL cholesterol (P = 0.018), whereas haptoglobin was unaffected. Hours of exercise week-1had a mild inverse association with hsCRP (P = 0.048) in non-OC users only.
  
  
  CONCLUSIONS
  OC use markedly elevated chronic low-grade inflammation in athletes, which could predispose to a higher inflammatory response to physical stress and elevate cardiovascular risk. Physical activity without OC use seemed to favor low hsCRP. Further research is needed to extend our results and to elucidate the potential effects on athletic performance of chronically elevated hsCRP. Our findings would be useful for sport physicians interpreting blood tests in athletes.
authors.affiliation: Department of Medical and Biological Sciences, School of Medicine, University of Udine, Piazzale Kolbe 4, Udine, 33100, Italy. sabina.cauci@uniud.it.
authors.forename: Sabina
authors.initials: S
authors.lastname: Cauci
authors.affiliation: Department of Medical and Biological Sciences, School of Medicine, University of Udine, Piazzale Kolbe 4, Udine, 33100, Italy.
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Francescato
authors.affiliation: Department of Medical and Biological Sciences, School of Medicine, University of Udine, Piazzale Kolbe 4, Udine, 33100, Italy.|Clinical Analysis Laboratory, Department of Laboratory Medicine, Institute of Clinical Pathology, Santa Maria della Misericordia University-Hospital, Udine, 33100, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Curcio
mesh_terms: D000293:Adolescent; D000328:Adult; D056352:Athletes; D002097:C-Reactive Protein / Q000032:analysis* / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000209:etiology; D002784:Cholesterol / Q000097:blood; D003277:Contraceptives, Oral, Combined / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D006242:Haptoglobins / Q000032:analysis* / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000150:complications; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D003277:Contraceptives, Oral, Combined; D006242:Haptoglobins; D014280:Triglycerides; D002097:C-Reactive Protein; D002784:Cholesterol