title: Metabolic safety of the etonogestrel contraceptive implant in healthy women over a 3-year period.
abstract: OBJECTIVE
  To ascertain whether placement of the etonogestrel contraceptive implant induces significant changes in carbohydrate and lipid metabolism, as reflected by metabolic parameters, in healthy women.
  
  
  METHODS
  Prospective cohort study of 213 healthy patients who received etonogestrel implants. Weight, BMI, blood pressure and a comprehensive metabolic profile were assessed at baseline, 1, 2 and 3 years. In 21 of the 213 participants, AUC for glucose levels, fasting insulin levels at baseline and year 3 (immediately before implant removal), HOMA-IR score, and the QUICK index were assessed. Parameters were expressed as median and interquartile range. The Wilcoxon test and ANOVA were used for comparison of measurements after implant placement (significance level p<0.05).
  
  
  RESULTS
  Median age was 26 years (range, 22-31.5). Results showed a trend toward increase of the variables weight (63.3-66.1) and BMI (24.7-25.7) and a decrease in TC (172-161.5), TG (75-69.5), and LDL (100.5-98.5) (p>0.05). Of the metabolic variables, FBG (85-88) and HDL (53-46) had significant differences (p<0.002). In the subgroup of 21 patients, there were reductions in insulin levels (9.65 vs. 8.4mU/dL, p=0.03), HOMA scores (2.06 vs. 1.75, p=0.02), QUICK index (0.34 vs. 0.35, p=0.03), TC (178 vs. 160mg/dL, p=0.001), HDL (51 vs. 46mg/dL, p=0.009), and LDL (110 vs. 100mg/dL, p=0.035).
  
  
  CONCLUSIONS
  These results provide evidence of the metabolic safety of the ENG implant in healthy women over a 3-year period. Indeed, implant placement induces changes consistent with a lower risk of insulin resistance and dyslipidemia.
authors.affiliation: Specialized in Obstetrics and Gynecology, Hysteroscopy, Sexually Transmitted Diseases and Sexual Violence, Porto Alegre, Brazil; Department of Obstetrics and Gynecology, Hospital Materno Infantil Presidente Vargas, Porto Alegre, Brazil.
authors.forename: Jaqueline
authors.initials: J
authors.lastname: Villas-Boas
authors.affiliation: Department of Obstetrics and Gynecology, Hospital Materno Infantil Presidente Vargas, Porto Alegre, Brazil; Obstetrics and Gynecology, Universidade Luterana do Brasil (ULBRA), Porto Alegre, Brazil.
authors.forename: Luiz C
authors.initials: LC
authors.lastname: Vilodre
authors.affiliation: Department of Obstetrics and Gynecology, Hospital Materno Infantil Presidente Vargas, Porto Alegre, Brazil; Public Health Nurse, Porto Alegre, Brazil.
authors.forename: Helena
authors.initials: H
authors.lastname: Malerba
authors.affiliation: Department of Obstetrics and Gynecology, Post-Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil; Services of Obstetrics and Gynecology, Complexo Hospitalar Santa Casa de Porto Alegre (ISCMPA), Porto Alegre, Brazil.
authors.forename: Mila
authors.initials: M
authors.lastname: Pontremoli Salcedo
authors.affiliation: Department of Obstetrics and Gynecology, Post-Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil; Services of Obstetrics and Gynecology, Complexo Hospitalar Santa Casa de Porto Alegre (ISCMPA), Porto Alegre, Brazil.
authors.forename: Mirela
authors.initials: M
authors.lastname: Foresti Jiménez
authors.affiliation: Department of Obstetrics and Gynecology, Post-Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil; Services of Obstetrics and Gynecology, Complexo Hospitalar Santa Casa de Porto Alegre (ISCMPA), Porto Alegre, Brazil. Electronic address: pbeitune@yahoo.com.br.
authors.forename: Patrícia
authors.initials: P
authors.lastname: El Beitune
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001835:Body Weight / Q000187:drug effects*; D003271:Contraceptive Agents, Female / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D017135:Desogestrel / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology; D011446:Prospective Studies; D016387:Women's Health; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; D007328:Insulin; C044815:etonogestrel; D017135:Desogestrel
keywords: Adverse effects; Body mass index; Carbohydrate metabolism; Etonogestrel implant; Lipid metabolism; Long-lasting contraception