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Insulin resistance, secretion, and metabolism in users of oral contraceptives.
J Clin Endocrinol Metab. 1992 Jan; 74(1):64-70.JC

Abstract

Studies of insulin employing the oral glucose tolerance test demonstrate marked differences between the effects of different oral contraceptives, but provide little insight into the underlying disturbances. We investigated the metabolic basis of these disturbances by computer modelling of iv glucose tolerance test glucose, insulin, and C-peptide concentration profiles. Insulin resistance, secretion, and metabolism were evaluated in 296 oral contraceptive users and 95 nonusers. Four estrogen/progestin combinations, with similar estrogen but differing progestin contents, and 1 progestin-only formulation were studied. Effects on iv glucose tolerance test glucose, insulin, and C-peptide concentrations varied according to progestin content, with levonorgestrel-containing combinations having the greatest effect, followed by desogestrel and norethindrone. However, these formulations increased insulin resistance to a similar extent. The progestin-only formulation did not affect insulin resistance. Levonorgestrel combinations increased second phase pancreatic insulin secretion by 60-90%, but did not affect the insulin half-life. The desogestrel combination increased the insulin half-life by 28%, but did not affect insulin secretion. The effects of different combined oral contraceptives on glucose tolerance test glucose, insulin, and C-peptide concentration profiles appears to be due to a combination of estrogen-induced insulin resistance and progestin-associated changes in insulin half-life.

Authors+Show Affiliations

Wynn Institute for Metabolic Research, St. John's Wood, London, England.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

1530790

Citation

Godsland, I F., et al. "Insulin Resistance, Secretion, and Metabolism in Users of Oral Contraceptives." The Journal of Clinical Endocrinology and Metabolism, vol. 74, no. 1, 1992, pp. 64-70.
Godsland IF, Walton C, Felton C, et al. Insulin resistance, secretion, and metabolism in users of oral contraceptives. J Clin Endocrinol Metab. 1992;74(1):64-70.
Godsland, I. F., Walton, C., Felton, C., Proudler, A., Patel, A., & Wynn, V. (1992). Insulin resistance, secretion, and metabolism in users of oral contraceptives. The Journal of Clinical Endocrinology and Metabolism, 74(1), 64-70.
Godsland IF, et al. Insulin Resistance, Secretion, and Metabolism in Users of Oral Contraceptives. J Clin Endocrinol Metab. 1992;74(1):64-70. PubMed PMID: 1530790.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Insulin resistance, secretion, and metabolism in users of oral contraceptives. AU - Godsland,I F, AU - Walton,C, AU - Felton,C, AU - Proudler,A, AU - Patel,A, AU - Wynn,V, PY - 1992/1/1/pubmed PY - 1992/1/1/medline PY - 1992/1/1/entrez KW - Biology KW - Carbohydrate Metabolic Effects KW - Contraception KW - Contraceptive Agents KW - Contraceptive Agents, Estrogen KW - Contraceptive Agents, Female KW - Contraceptive Agents, Progestin KW - Contraceptive Methods KW - Desogestrel KW - Developed Countries KW - England KW - Ethinyl Estradiol KW - Europe KW - Examinations And Diagnoses KW - Family Planning KW - Glucose Metabolism Effects KW - Glucose Tolerance Test KW - Laboratory Examinations And Diagnoses KW - Laboratory Procedures KW - Levonorgestrel KW - Metabolic Effects KW - Models, Theoretical KW - Norethindrone KW - Northern Europe KW - Oral Contraceptives KW - Oral Contraceptives, Combined KW - Oral Contraceptives, Low-dose KW - Oral Contraceptives, Phasic KW - Physiology KW - Progestins, Low-dose KW - Research Methodology KW - Research Report KW - United Kingdom SP - 64 EP - 70 JF - The Journal of clinical endocrinology and metabolism JO - J Clin Endocrinol Metab VL - 74 IS - 1 N2 - Studies of insulin employing the oral glucose tolerance test demonstrate marked differences between the effects of different oral contraceptives, but provide little insight into the underlying disturbances. We investigated the metabolic basis of these disturbances by computer modelling of iv glucose tolerance test glucose, insulin, and C-peptide concentration profiles. Insulin resistance, secretion, and metabolism were evaluated in 296 oral contraceptive users and 95 nonusers. Four estrogen/progestin combinations, with similar estrogen but differing progestin contents, and 1 progestin-only formulation were studied. Effects on iv glucose tolerance test glucose, insulin, and C-peptide concentrations varied according to progestin content, with levonorgestrel-containing combinations having the greatest effect, followed by desogestrel and norethindrone. However, these formulations increased insulin resistance to a similar extent. The progestin-only formulation did not affect insulin resistance. Levonorgestrel combinations increased second phase pancreatic insulin secretion by 60-90%, but did not affect the insulin half-life. The desogestrel combination increased the insulin half-life by 28%, but did not affect insulin secretion. The effects of different combined oral contraceptives on glucose tolerance test glucose, insulin, and C-peptide concentration profiles appears to be due to a combination of estrogen-induced insulin resistance and progestin-associated changes in insulin half-life. SN - 0021-972X UR - https://www.unboundmedicine.com/medline/citation/1530790/Insulin_resistance_secretion_and_metabolism_in_users_of_oral_contraceptives_ L2 - https://academic.oup.com/jcem/article-lookup/doi/10.1210/jcem.74.1.1530790 DB - PRIME DP - Unbound Medicine ER -