Abstract
Purpose: To evaluate markers of cardiovascular disease in women with normal insulin sensitivity who had recently initiated use of depot medroxyprogesterone acetate (DMPA) as a contraceptive.
Materials and methods: A prospective, non-randomised, comparative study. Data of 30 women of 18–40 years of age, with normal hyperinsulinaemic–euglycaemic clamp at baseline and body mass index (BMI) < 30, who opted to use DMPA or a copper intrauterine device (IUD) as a contraceptive, were analysed. Serum samples were collected for evaluation of the lipid and hepatic profile, C-reactive protein, TNF-α, interleukin-6, leptin/adiponectin ratio and free fatty acids; body composition was evaluated using DXA, blood pressure and carotid intima-media thickness were measured. Evaluations were performed at baseline and 12 months later. The groups were compared using repeated measures analysis of variance (ANOVA). Significance level was 5%.
Results: The mean age of the women in the DMPA and IUD group was 28.7 ± 6.5 and 28.3 ± 5.8 years, respectively; the BMI was 23.0 ± 3.4 and 24.3 ± 2.7 kg/m2, respectively, in the same groups. At 12 months, triglyceride levels were higher in the DMPA group compared to the IUD group and there was an increase in apolipoprotein B-100 in relation to baseline in DMPA group; there were no other difference between the groups.
Conclusions: No clinical cardiovascular effect was found but deterioration in CV markers was observed in the first year of use of DMPA.
摘要
目的:评估近期开始用长效醋酸甲羟孕酮(DMPA)避孕的胰岛素敏感性正常的女性心血管疾病的标志物。
材料和方法:前瞻性、非随机对照研究。分析了30例18-40岁胰岛素及血糖水平位于正常基线的女性, 且选择用DMPA和宫内节育器(IUD)作为避孕用具。搜集血清标本评估血脂和肝脏形态、C反应蛋白、TNF-a、白细胞介素-6、瘦蛋白/脂肪连接蛋白比例及游离脂肪酸;采用DXA法测定体成分, 测量血压及颈动脉内膜-中膜厚度。分别于基线和12个月后进行评估。采用重复测量方差分析(ANOVA)对各组进行比较。显著性水平为5%。
结果:DMPA组女性平均年龄为28.7 ± 6.5岁, IUD组女性平均年龄为28.3 ± 5.8岁;各组的BMI分别为23.0 ± 3.4和24.3 ± 2.7kg/m2。12个月后, DMPA组甘油三酯水平明显高于IUD组, 载脂蛋白B-100相对基线有升高;两组之间无其他差异。
结论:应用DMPA的第一年未发现明显临床心血管影响, 但是CV指标有明显下降。
Disclosure statement
The authors report no conflicts of interest.