Effects of combined oral contraceptives containing levonorgestrel or chlormadinone on the endothelium
Effects of combined oral contraceptives containing levonorgestrel or chlormadinone on the endothelium
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DOI：
10.1016/j.contraception.2012.09.023
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发表时间：
2013-06-01
期刊：
影响因子：
2.9
通讯作者：
Ferriani, Rui Alberto
中科院分区：
文献类型：
--
作者：
Franceschini, Silvio Antonio;Vieira, Carolina Sales;Ferriani, Rui Alberto
背景资料：虽然使用复方口服避孕药（COCs）与动脉和静脉血栓栓塞事件的风险增加有关，但关于COCs对内皮功能的影响知之甚少。本研究评估了30 mcg乙炔炔雌醇（EE）/2 mg醋酸氯地孕酮（CMA）和30 mcg EE/150 mcg左炔诺孕酮（LNG）组合对健康女性内皮的影响。对64名健康女性进行了评价，其中21名使用非激素避孕方法（对照），43名使用COCs，随机分配至EE 30 mcg /CMA 2 mg或EE 30 mcg/LNG 150 mcg。在随机分组和6个月后测量人体测量参数、动脉收缩压（SAP）、动脉舒张压（DAP）、内皮功能超声标记物、肱动脉血流介导的舒张（FMD）、内膜中层厚度（IMT）和颈总动脉硬度。相对于基线，EE/CMA使用者在6个月时的平均DAP显著降低EE/LNG使用者在6个月时平均IMT显著增加（p=.02），平均FMD显著降低（p=.01）。COC使用者6个月时的DAP显著低于对照组（p= 0.01）。组间评估显示，6个月时，EE/LNG使用者的平均SAP（p=.02）显著低于对照组（p=.02），EE/CMA使用者的平均DAP显著低于对照组（p
Background: Although the use of combined oral contraceptives (COCs) is associated with an increased risk of arterial and venous thromboembolic events, less is known about the impact of COCs on endothelial function. The present study evaluated the effects on the endothelium of healthy women of combinations of 30 mcg ethinylestradiol (EE)/2 mg chlormadinone acetate (CMA) and 30 mcg EE/150 mcg levonorgestrel (LNG).Study Design: Sixty-four healthy women were evaluated, 21 using a nonhormonal contraceptive method (control) and 43 using COCs, randomized to EE 30 mcg /CMA 2 mg or to EE 30 mcg/LNG 150 mcg. Anthropometric parameters, systolic arterial pressure (SAP), diastolic arterial pressure (DAP), ultrasound markers of endothelial function, flow-mediated dilation (FMD) of the brachial artery, intima media thickness (IMT) and common carotid artery stiffness were measured at randomization and 6 months later.Results: Relative to baseline, EE/CMA users showed a significant reduction in mean DAP at 6 months (p=.02), and EE/LNG users showed a significant increase in mean IMT (p=.02) and a significant reduction in mean FMD (p=.01) at 6 months. DAP at 6 months was significantly lower in COC users than in controls (p=.01). Intergroup evaluations showed that, at 6 months, mean SAP (p=.02) was significantly lower in EE/LNG users than in controls (p=.02) and that mean DAP was significantly lower in EE/CMA (p