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Effect of second and third generation oral contraceptives on lipid metabolism in the absence or presence of the factor V Leiden mutation
Author(s) -
Kemmeren J. M.,
Algra A.,
Grobbee D. E.
Publication year - 2001
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1046/j.1365-2796.2001.00906.x
Subject(s) - desogestrel , levonorgestrel , medicine , ethinylestradiol , endocrinology , gestodene , pill , cholesterol , population , family planning , pharmacology , research methodology , environmental health
. Kemmeren JM, Algra A, Grobbee DE (University Medical Center Utrecht, Utrecht, The Netherlands). Effect of second and third generation oral contraceptives on lipid metabolism in the absence or presence of the factor V Leiden mutation. J Intern Med 2001; 250 : 441–448. Objectives. The effect of a second and third generation oral contraceptive and of the progestagens used in these pills on lipid metabolism was studied in the absence or presence of the factor V Leiden mutation. Design. A single centre, double blind randomized trial. Setting. University Medical Centre. Subjects. A total of 51 women without and 35 women with the factor V Leiden mutation. Interventions. A second generation (30 μg ethinylestradiol/150 μg levonorgestrel) or a third generation (30 μg ethinylestradiol/150 μg desogestrel) oral contraceptive. After two cycles of use and a wash‐out period of two cycles, the participants received the corresponding progestagen‐only preparation containing 150 μg levonorgestrel or 150 μg desogestrel. Main outcome measures. Mean difference in changes between the treatment groups on total cholesterol, HDL, LDL, triglycerides and total/HDL cholesterol ratio. Results. Compared with levonorgestrel, desogestrel‐containing oral contraceptives caused in women without the factor V Leiden mutation significant changes in HDL (0.43; 95% confidence interval [CI] 0.25–0.61), LDL (–0.55; 95% CI –0.90 to –0.20), triglycerides (0.19; 95% CI 0.06–0.32) and total/HDL cholesterol ratio (–0.87; 95% CI –1.21 to –0.53). When the progestagen‐only preparations were used, differential changes were found for HDL (0.16; 95% CI 0.03–0.29), LDL (–0.31; 95% CI –0.56 to –0.05) and total/HDL cholesterol ratio (−0.55; 95% CI –0.84 to –0.26). Desogestrel‐only caused changes opposite to those of desogestrel‐containing oral contraceptives. For cholesterol and triglycerides, this effect was also found for levonorgestrel‐only in comparison with levonorgestrel‐combined oral contraceptives. Levonorgestrel appeared to induce the effect on HDL. Almost all results were similar for women with the factor V Leiden mutation. Conclusion. It appears that desogestrel counteracts the effects of oestrogens to a lesser extent than levonorgestrel. Desogestrel‐containing oral contraceptives have therefore a more favourable influence on cholesterol metabolism in comparison with levonorgestrel‐containing oral contraceptives.