Treatment of hirsutism with ethinyl estradial-desogestrel contraceptive pills has beneficial effects on the lipid profile and improves insulin sensitivity
Treatment of hirsutism with ethinyl estradial-desogestrel contraceptive pills has beneficial effects on the lipid profile and improves insulin sensitivity
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DOI：
10.1016/s0015-0282(00)00718-4
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发表时间：
2000-10-01
影响因子：
6.7
通讯作者：
Sancho, J
中科院分区：
文献类型：
--
作者：
Escobar-Morreale, HF;Lasunción, MA;Sancho, J
目的：评价含有30 μ g炔雌醇和150 μ g去氧孕烯的口服避孕药对多毛妇女的脂质模式和胰岛素敏感性的影响。设计：前瞻性临床研究。设置：三级保健机构医院。患者：16名多毛妇女。干预：在基线和接受6个周期口服避孕药治疗后对妇女进行评价。主要结果测量：体重指数（BMI）;多毛症评分（九个身体区域）;血清总胆固醇、高密度脂蛋白（HDL）胆固醇、低密度脂蛋白（LDL）胆固醇、甘油三酯、载脂蛋白B、脂蛋白（a）和血清肾上腺和卵巢雄激素水平;以及空腹血糖和胰岛素浓度。平均血清总胆固醇、高密度脂蛋白和低密度脂蛋白胆固醇水平在6个周期的口服避孕药治疗后升高。基线时16名患者中有7名患者的HDL胆固醇水平< 50 mg/dL;治疗后3名患者的这些水平正常化。所有患者治疗前后血清总胆固醇和低密度脂蛋白胆固醇均在正常范围内。血清甘油三酯、载脂蛋白B和脂蛋白（a）浓度未观察到显著变化。通过稳态模型评估分析的空腹胰岛素水平和胰岛素抵抗在治疗后显著降低。未观察到BMI变化。口服避孕药可显著降低多毛症评分和高雄激素血症。结论：口服避孕药含低剂量炔雌醇和去氧孕烯可有效控制多毛症和高雄激素血症，改善多毛症妇女的代谢异常。（Fertil Steril（R）2000;74：816-9. (C)美国生殖医学会（American Society for Reproductive Medicine）。
Objective: To evaluate the effects on the lipid pattern and insulin sensitivity of hirsute women of an oral contraceptive pill containing 30 mu g of ethinyl estradiol and 150 mu g of desogestrel.Design: Prospective clinical study.Setting: Tertiary care institutional hospital.Patient(s): 16 hirsute women.Intervention(s): Women were evaluated at baseline and after receiving six cycles of oral contraceptive therapy.Main Outcome Measure(s): Body mass index (BMI); hirsutism score (nine body areas); serum levels of total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, apolipoprotein B, lipoprotein(a), and serum adrenal and ovarian androgens; and fasting glucose and insulin concentrations.Result(s): The mean serum total, HDL, and LDL cholesterol levels increased after six cycles of oral contraceptive therapy. Levels of HDL cholesterol were < 50 mg/dL in 7 of the 16 patients at baseline; these levels normalized in 3 patients after treatment. Serum total and LDL cholesterol remained within the normal range in all patients before and after therapy. No significant changes were observed in serum triglyceride, apolipoprotein B and lipoprotein(a) concentrations. Fasting insulin levels and insulin resistance as analyzed by homeostasis model assessment were reduced significantly after therapy. No changes in BMI were observed. Administration of oral contraceptive pills significantly reduced the hirsutism score and hyperandrogenemia.Conclusion(s): Oral contraceptive pills containing low-dose ethinyl estradiol and desogestrel are effective in controlling hyperandrogenism and hirsutism and ameliorate the abnormal metabolic profile of women with hirsutism. (Fertil Steril (R) 2000;74:816-9. (C) 2000 by American Society for Reproductive Medicine.).