ORAL CONTRACEPTIVES IN METABOLIC SYNDROME

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。口服避孕药（OCs）是最广泛使用的可逆避孕方法。然而，广泛使用的低剂量OCs（乙炔雌二醇< 50 g）的长期心血管安全性仍存在争议。尽管心血管事件在年轻女性中很少见，无论她们是否使用OCs，但具有传统心血管危险因素（如吸烟、糖尿病或高胆固醇血症）的OCs使用者中心肌梗死和缺血性中风的风险增加。然而，具有新出现的心血管危险因素的口服避孕药使用者的心血管事件风险尚未被调查。其中一个新出现的心血管危险因素是代谢综合征。最近，代谢综合征与心血管疾病的风险有关。该综合征是单一个体的危险因素聚集，其潜在原因可能是胰岛素抵抗。研究者的长期目标是了解预防和治疗女性心血管疾病的最佳方法。这项特殊应用的目的是获得代谢综合征对服用OCs的妇女心血管风险影响程度的试点数据。我们假设代谢综合征预示着OC使用者更高的心血管风险。这项研究的结果将阐明服用OCs的女性心血管事件的危险因素，并将作为NIH提案的试点数据。一旦了解了口服避孕药使用者的心血管危险因素，临床医生就可以对患者的避孕选择做出更明智的决定。拟议的研究是创新的，因为代谢综合征对OC使用者心血管危险因素的影响以前没有研究过。在这些研究完成后，我们的预期是使用OCs会加重代谢综合征女性的胰岛素抵抗、高凝性和炎症标志物。总的来说，这些研究的结果将澄清适当的OCs候选物，以便在危害最小的情况下适当使用OCs。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Oral contraceptives (OCs) are the most widely used method of reversible birth control. However, the long-term cardiovascular safety of the widely used low-dose OCs (ethinyl-estradiol < 50 g) is still debated. Although cardiovascular events are rare in young women whether they use OCs or not, the risks of myocardial infarction and ischemic stroke are increased among users of OCs who have conventional cardiovascular risk factors such as use of tobacco, diabetes or hypercholesterolemia. However, the risk of cardiovascular events in OC users with emerging cardiovascular risk factors have not been investigated. One such emerging cardiovascular risk factor is the metabolic syndrome. Recently, the metabolic syndrome has been linked with the risk of cardiovascular disease. The syndrome is a clustering of risk factors in a single individual, and its underlying cause may be insulin resistance. The investigator's long-term goal is to understand the best way to prevent and treat cardiovascular disease in women. The objective of this particular application is to obtain pilot data on the extent to which the metabolic syndrome affects cardiovascular risks in women taking OCs. We hypothesize that the metabolic syndrome predicts higher cardiovascular risks in OC users. Results of this study will clarify the risk factors for cardiovascular events in women taking OCs, and will serve as pilot data for an NIH proposal. Once the cardiovascular risk factors of OC users are understood, clinicians can make better informed decisions about contraceptive choices in their patients. The proposed research is innovative, because the effects of the metabolic syndrome on cardiovascular risk factors in OC users have not been previously studied. At the completion of these studies, our expectation is that use of OCs worsens insulin resistance, hypercoagulability and inflammatory markers in women with the metabolic syndrome. Collectively, the results of these studies will clarify the proper candidates for OCs, so that the appropriate use of OCs with the least harm will be possible.