Pharmacokinetics of Hormonal Contraception in Individuals with Obesity: a Review.
Pharmacokinetics of Hormonal Contraception in Individuals with Obesity: a Review.
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肥胖个体激素避孕药的药代动力学：综述。
DOI：
10.1007/s13669-020-00284-y
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发表时间：
2020-06
影响因子：
0.5
通讯作者：
Edelman A
中科院分区：
文献类型：
--
作者：
Ramanadhan S;Jusko WJ;Edelman A
肥胖继续影响着全球许多女性。在美国，几乎40%的女性肥胖，其中许多女性使用激素避孕来预防怀孕。激素避孕药对这些人的效果如何一直是一个正在进行的研究领域。药代动力学（PK），研究药物通过身体，可以揭示肥胖和非肥胖人群之间的生理差异如何影响药物分布和随后的疗效。本综述旨在反思这些类型的研究，并为临床医生提供信息，以帮助应对肥胖流行病的挑战，并帮助他们为患者提供最佳的避孕选择。在这里，我们介绍了激素避孕作用机制的基础知识，基本的药代动力学原理，以及药代动力学，肥胖和激素避孕的最新研究。新的研究集中在激素避孕药在肥胖女性中的药代动力学表明，虽然类固醇激素在不同体重指数的女性中的处理方式存在明显差异，但避孕效果可能是相同的。这在涉及各种激素避孕方法的研究中得到了重复。PK研究允许详细分析肥胖个体中类固醇激素的处理。通过观察这些激素通过身体的每个阶段的PK参数，研究人员已经深入研究了伴随肥胖的生理差异。然而，在审查这些PK参数差异时，似乎虽然过程不同，但在肥胖背景下，妊娠预防的最终结果可能不会受到影响。紧急避孕的作用机制与连续性激素避孕不同，是肥胖症已被证明影响疗效的一个领域。
Obesity continues to affect many women globally. In the USA, almost 40% of all women are obese and many of these women use hormonal contraception for pregnancy prevention. How well hormonal contraceptive works for these individuals has been an area of ongoing research. Pharmacokinetics (PK), the study of drug passage through the body, can shed light on how differences in physiology between obese and non-obese populations can impact drug disposition and subsequent efficacy. This review aims to reflect on these types of studies and empower clinicians with information to help tackle the challenges of the obesity epidemic and help them provide the best contraceptive options to their patients. Here, we present the basics of the mechanisms of action of hormonal contraception, fundamental pharmacokinetic principles, and the latest research into pharmacokinetics, obesity, and hormonal contraception. New studies focused on the PK of hormonal contraception in women with obesity have shown that while there are distinct differences in how steroid hormones are processed in women with different body mass indices, contraceptive efficacy is likely the same. This is replicated in studies involving a variety of hormonal contraceptive methods. PK studies allow for a detailed analysis of steroid hormone processing in individuals with obesity. Observing PK parameters at each stage of the passage of these hormones through the body, researchers have drilled down on physiologic differences that accompany obesity. In reviewing these PK parameter differences, however, it appears that while processes are different, the end result of pregnancy prevention is likely not compromised in the setting of obesity. Emergency contraception, which functions by a different mechanism from that of continuous hormonal contraception, is the one area in which obesity has been demonstrated to impact efficacy.
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影响因子：
2.9
作者：
Edelman, Alison B.;Cherala, Ganesh;Jensen, Jeffrey T.
通讯作者：
Jensen, Jeffrey T.
影响因子：
2.9
作者：
Reinecke, Isabel;Hofmann, Birte;Garmann, Dirk
通讯作者：
Garmann, Dirk
影响因子：
13.6
作者：
Henegar, JR;Bigler, SA;Hall, JE
通讯作者：
Hall, JE
影响因子：
2.9
作者：
Luo, Dandan;Westhoff, Carolyn L.;Jusko, William J.
通讯作者：
Jusko, William J.
影响因子：
2.9
作者：
Westhoff, Carolyn L.;Reineeke, Isabel;Merz, Martin
通讯作者：
Merz, Martin