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Secondary dyslipidaemia after oral contraceptives


Authors: Soška 1,2;  J. Fiala 3;  K. Nebeská 3;  D. Hrubá 3
Authors‘ workplace: Oddělení klinické biochemie FN u sv. Anny Brno, přednosta doc. MUDr. Vladimír Soška, CSc. 1;  II. interní klinika Lékařské fakulty MU a FN u sv. Anny Brno, přednosta prof. MUDr. Miroslav Souček, CSc. 2;  Ústav preventivního lékařství Lékařské fakulty MU Brno, přednostka prof. MUDr. Zuzana Brázdová, DrSc. 3
Published in: Vnitř Lék 2009; 55(10): 929-933
Category: Original Contributions

Overview

The aim of the study:
To examine changes to blood lipid and lipoprotein levels following introduction of modern oral hormonal contraception agents and to evaluate atherogenic character of this dyslipidemia. Methods, patient sample: Forty four women of the mean age of 22.7 ± 3.5 years, BMI 21.4 ± 2.5 kg/sqm, waste line 71.9 ± 7.1 cm and BP 115.7 ± 12.2/70.1 ± 8.3 mm Hg were included. Total cholesterol, HDL‑cholesterol, LDL‑cholesterol, triglycerides, apolipoprotein A1 and apolipoprotein B levels were assessed before the introduction of contraception and 3 months into the treatment. Results: Following 3 months of treatment, increase in the total cholesterol (4.19 ± 0.80 vs 4.75 ± 0.79 mmol/l; p < 0.001), LDL‑cholesterol (2.10 ± 0.64 vs 2.32 ± 0.66 mmol/l; p = 0.23), HDL‑cholesterol (1.71 ± 0.42 vs 1.90 ± 0.45 mmol/l; p < 0.001), triglycerides (0.85 ± 0.36 vs 1.18 ± 0.50 mmol/l; p < 0.001), apolipoprotein A1 (1.55 ± 0.33 vs 1.88 ± 0.44 g/l; p < 0.001) and apolipoprotein B (0.58 ± 0.15 vs 0.69 ± 0.19 g/l; p < 0.001) levels was observed. The total cholesterol/HDL cholesterol and apolipoprotein B/apolipoprotein A1 ratios have not changed significantly between the two assessments.

Conclusion:
Three‑month treatment with combined hormonal contraception resulted in statistically significantly increased concentrations of triglycerides, total cholesterol, HDL‑cholesterol, LDL‑cholesterol, apolipoprotein A1 and apolipoprotein B. At the same time, total cholesterol/HDL cholesterol and apolipoprotein B/apolipoprotein A1 ratios have not changed significantly and thus hormonal contraception‑induced dyslipidemia should not be regarded as proatherogenic.

Key words:
hormonal contraception – dyslipidemia – apolipoprotein A1 – apolipoprotein B


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