EFFECTS OF ORAL-CONTRACEPTIVES ON LIPOPROTEIN LIPIDS - A PROSPECTIVE-STUDY

  • 1 January 1984
    • journal article
    • research article
    • Vol. 63  (6) , 764-770
Abstract
Healthy women (169), aged 17-29 yr, nonsmokers or light smokers (fewer than 10 cigarettes per day), were assigned randomly to take 1 of 5 oral contraceptives: 100 .mu.g mestranol plus 0.5 mg ethynodiol diacetate (100 M + 0.5 ED); 100 .mu.g mestranol plus 1.0 mg ethynodiol diacetate (100 M + 1.0 ED); 50 .mu.g ethinyl estradiol plus 1.0 mg ethynodiol diacetate (50 EE + 1.0 ED); 30 .mu.g ethinyl estradiol plus 2.0 mg ethynodiol diacetate (30 EE + 2.0 ED) or 30 .mu.g ethinyl estradiol plus 0.15 mg levonorgestrel (30 EE + 0.15 NG). Women (147) completed the study. When assessed for within-group differences, all preparations caused a statistically significant increase in total triglyceride (from 17.0 to 46.4 mg/dl), total cholestrol (from 6.3 to 24.4 mg/dl) and low density lipoprotein (LDL) cholestrol (from 7.0 to 10.3 mg/dl). Effects on high density lipoprotein (HDL) cholesterol varied widely. The product 100 M + 0.5 ED markedly increased (9.9 mg/dl) HDL cholesterol. Neither 100 M + 1.0 ED nor 50 EE + 1.0 ED altered HDL cholesterol levels; both preparations containing 30 .mu.g estrogen showed decreases: the preparation containing 2.0 mg ethynodiol diacetate lowered HDL cholesterol by 3.6 mg/dl and that containing 0.15 mg levonorgesterol lowered it by 6.9 mg/dl. Specific between-group comparisons revealed no statistically significant differences between differing amounts of estrogen (50 EE + 1.0 ED vs. 100 M + 1.0 ED). Women receiving less progestogen (100 M + 0.5 ED), however, had significantly higher total cholesterol, HDL cholesterol and HDL triglyceride when comapred with 100 M + 1.0 ED, containing more progestogen. As there was less variation from baseline in the 100 M + 1.0 ED group, the higher dose of progestogen in this group more closely balanced the effects of 100 .mu.g of mestranol. Although the differences between 30 EE + 2.0 ED and 30 EE + 0.15 NG were not statistically significant, the adjusted mean HDL cholesterol levels in the 30 EE + 2.0 ED group were higher (57.6 mg/dl) than in the 30 EE + 0.15 NG group (54.0 mg/dl). Oral contraceptives should be regarded as differing in their potential for altering lipoprotein lipid levels, and the absolute steroid content of an oral contraceptive is not the oly indicator of its effects upon lipid metabolism.