Cholesterol fractions and apolipoproteins during endometriosis treatment by a gonadotrophin releasing hormone (GnRH) agonist implant or by danazol

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Abstract
Summary. objective The evaluation of cholesterol fractions and apoproteins during ovarian suppression by a GnRH agonist implant vs danazol in the treatment of endometriosis design A randomized study in 33 patients comparing goserelin (3.6 mg/4 weeks s.c., n= 20) with danazol (2 ± 400 mg/day p.o., n= 13) in patients with a laparoscopic diagnosis of endometriosis and treated for 6 months. Triglycerides, cholesterol (C), LDL‐C, HDL‐C subtractions and apoproteins A‐1 and B were measured at admission, at months 2, 4 and 6 of treatment and at month 2 post‐treatment. results After 1 month of therapy, serum oestradiol levels were maintained in the menopausal range with goserelin and in the early follicular phase range with danazol. Goserelin induced a significant elevation in HDL‐C (by 31.4%), in HDL2‐C (24.6%) and in HDL3‐C (45.7%) but no significant change in LDL‐C or in ApoA‐1 and ApoB. By contrast, danazol caused significant diminutions in HDL‐C (23.9%), HDL,‐C (56.6%) and ApoA‐1 (35.6%). Moreover, danazol increased LDL‐C (10.5%) and ApoB (29.0%, P < 0.05). The lipoprotein changes during goserelin had a favourable effect on the atherogenic index (cholesterol/HDL‐C) and ApoA‐1/ApoB ratio whereas those of danazol had opposite effects. These changes reverted 2 months after danazol while HDL was still elevated after goserelin. conclusions In relation to cholesterol, goserelin is a safe medication. The significance of temporary adverse changes in cholesterol fractions due to danazol Is still unknown.