Modification of body composition and metabolism during oral contraceptives containing non-androgenic progestins in association with estradiol or ethinyl estradiol

Abstract

Aim: To observe the influence on metabolism and body composition of two oral contraceptives containing non-androgenic progestins in association with estradiol or ethinyl estradiol (EE).

Study design: Women on hormonal contraception with estradiol valerate (E2V)/dienogest (DNG) in a quadriphasic regimen (n = 16) or 30 μg EE/2 mg chlormadinone acetate (CMA) (n = 16) in a monophasic regimen were evaluated at the third cycle for modifications in lipoproteins, apoproteins and homeostatic model assessment for insulin resistance (HOMA-IR), and at the sixth cycle for body composition and the markers of bone turnover osteocalcin and C-telopeptide X.

Results: During E2V/DNG lipoprotein, apoproteins and HOMA-IR remained stable. During EE/CMA, total-cholesterol (p = 0.003), high-density lipoprotein (HDL)-cholesterol (p = 0.001), triglycerides (p = 0.003) Apoprotein-A1 (Apo-A1; p = 0.001) and Apo B (p = 0.04) increased, low-density lipoprotein/HDL (p = 0.039) decreased and total-cholesterol/HDL and Apoprotein-B/Apo-A1 ratio did not vary. HOMA-IR slightly increased from 1.33 ± 0.87 to 1.95 ± 0.88 (p = 0.005). There was a reduction of markers of bone metabolism in both groups with no modification of body composition.

Conclusions: Administration of E2V/DNG does not influence lipid and glucose metabolism, while mixed effect are exerted by EE/CMA. Both preparations reduce bone metabolism without influencing short-term effect on body composition.

Chinese abstract

目的：观察成分为非雄激素活性孕激素联合雌二醇或炔雌醇（EE）的两种口服避孕药对人体代谢及体成份的影响。

研究设计：受试者口服激素避孕药戊酸雌二醇（E2V）/地诺孕素（DNG）四相药片（n = 16）或30 μg EE/2 mg 醋酸氯地孕酮（CMA）单相药片（n = 16），于第3周期评估脂蛋白、载脂蛋白及胰岛素抵抗稳态模型评估（HOMA-IR），于第6周期评估体成份与骨代谢骨钙素及C-端肽X标志物。

结果：服用E2V/DNG期间脂蛋白、载脂蛋白及HOMA-IR水平稳定。而服用EE/CMA期间，总胆固醇（p = 0.003）、高密度脂蛋白（HDL）-胆固醇（p = 0.001）、甘油三酯（p = 0.003）、载脂蛋白-A1（Apo-A1; p = 0.001）和载脂蛋白B（Apo B; p = 0.04）水平均升高，低密度脂蛋白/高密度脂蛋白（p = 0.039）比率下降，总胆固醇/高密度脂蛋白与Apo-A1/Apo B比率没有变化。HOMA-IR由1.33±0.87小幅上升至1.95±0.88（p = 0.005）。两组骨代谢标志物均有所下降，体成份没有明显变化。

结论：服用E2V/DNG不影响血脂与血糖代谢，而EE/CMA会产生混合性影响。两种方案均可降低骨代谢，在短期内不影响体成份。

• Bone
• chlormadinone acetate
• dienogest
• estradiol
• hormonal contraception
• insulin
• lipids