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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.
J Intern Med. 2001 Nov; 250(5):441-8.JI

Abstract

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 microg ethinylestradiol/150 microg levonorgestrel) or a third generation (30 microg ethinylestradiol/l 50 microg 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 microg levonorgestrel or 150 microg 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.

Authors+Show Affiliations

Julius Center for General Practice and Patient Oriented Research, University Medical Center Utrecht, The Netherlands.No affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11887980

Citation

Kemmeren, J M., et al. "Effect of Second and Third Generation Oral Contraceptives On Lipid Metabolism in the Absence or Presence of the Factor V Leiden Mutation." Journal of Internal Medicine, vol. 250, no. 5, 2001, pp. 441-8.
Kemmeren JM, Algra A, Grobbee DE. 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(5):441-8.
Kemmeren, J. M., Algra, A., & Grobbee, D. E. (2001). Effect of second and third generation oral contraceptives on lipid metabolism in the absence or presence of the factor V Leiden mutation. Journal of Internal Medicine, 250(5), 441-8.
Kemmeren JM, Algra A, Grobbee DE. 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(5):441-8. PubMed PMID: 11887980.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of second and third generation oral contraceptives on lipid metabolism in the absence or presence of the factor V Leiden mutation. AU - Kemmeren,J M, AU - Algra,A, AU - Grobbee,D E, PY - 2002/3/13/pubmed PY - 2002/3/22/medline PY - 2002/3/13/entrez SP - 441 EP - 8 JF - Journal of internal medicine JO - J Intern Med VL - 250 IS - 5 N2 - 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 microg ethinylestradiol/150 microg levonorgestrel) or a third generation (30 microg ethinylestradiol/l 50 microg 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 microg levonorgestrel or 150 microg 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. SN - 0954-6820 UR - https://www.unboundmedicine.com/medline/citation/11887980/Effect_of_second_and_third_generation_oral_contraceptives_on_lipid_metabolism_in_the_absence_or_presence_of_the_factor_V_Leiden_mutation_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0954-6820&date=2001&volume=250&issue=5&spage=441 DB - PRIME DP - Unbound Medicine ER -