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Insulin sensitivity and lipid metabolism with oral contraceptives containing chlormadinone acetate or desogestrel: a randomized trial.
Contraception. 2009 Feb; 79(2):111-6.C

Abstract

BACKGROUND

Second-generation and third-generation oral contraceptives containing 30 mcg or more of ethinylestradiol (EE) decrease insulin sensitivity (SI). In this study, we investigated whether SI is decreased by contraceptives containing lower doses EE or by progestins with antiandrogenic properties.

STUDY DESIGN

Twenty-eight young healthy women were randomly allocated to receive 20 mcg of EE and 150 mcg of desogestrel (DSG) (n=14) or 30 mcg of EE and 2 mg of chlormadinone acetate (CMA) (n=14) for 6 months. SI and glucose utilization independent of insulin (Sg) were investigated by the minimal model method. Lipid modifications were also analyzed.

RESULTS

SI decreased with EE/DSG (7.09+/-1.4 vs. 4.30+/-0.91; p=.04; n=12), but not with EE/CMA (5.79+/-0.93 vs. 6.79+/-1.1; p=.48; n=12). SI modifications observed in the two groups were significantly different (-2.79+/-1.15 vs. 1.0+/-1.38; p=.05). Sg did not vary with either treatment. The response of C-peptide to glucose increased, but significantly so only with EE/CMA (p=.01). The C-peptide/insulin response increased with both EE/DSG (p=.05) and EE/CMA (p=.04). High-density lipoprotein (HDL) cholesterol (p=.02) and triglycerides (p=.02 and p=.01) increased in both groups, but HDL/low-density lipoprotein cholesterol (p=.02), apoprotein A1 (Apo-A1) (p=.04) and Apo-A1/apoprotein B (p=.048) increased significantly only with EE/CMA.

CONCLUSIONS

The present study confirms that DSG, even when associated with low EE dose, decreases SI. By contrast, EE/CMA does not deteriorate SI and induces a favorable lipid profile.

Authors+Show Affiliations

Department of Obstetrics, Gynecology and Pediatrics, Gynecology and Obstetrics Unit, University of Modena, Policlinico of Modena, Via del Pozzo 71, Modena, Italy. cagnacci@unimore.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

19135567

Citation

Cagnacci, Angelo, et al. "Insulin Sensitivity and Lipid Metabolism With Oral Contraceptives Containing Chlormadinone Acetate or Desogestrel: a Randomized Trial." Contraception, vol. 79, no. 2, 2009, pp. 111-6.
Cagnacci A, Ferrari S, Tirelli A, et al. Insulin sensitivity and lipid metabolism with oral contraceptives containing chlormadinone acetate or desogestrel: a randomized trial. Contraception. 2009;79(2):111-6.
Cagnacci, A., Ferrari, S., Tirelli, A., Zanin, R., & Volpe, A. (2009). Insulin sensitivity and lipid metabolism with oral contraceptives containing chlormadinone acetate or desogestrel: a randomized trial. Contraception, 79(2), 111-6. https://doi.org/10.1016/j.contraception.2008.09.002
Cagnacci A, et al. Insulin Sensitivity and Lipid Metabolism With Oral Contraceptives Containing Chlormadinone Acetate or Desogestrel: a Randomized Trial. Contraception. 2009;79(2):111-6. PubMed PMID: 19135567.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Insulin sensitivity and lipid metabolism with oral contraceptives containing chlormadinone acetate or desogestrel: a randomized trial. AU - Cagnacci,Angelo, AU - Ferrari,Serena, AU - Tirelli,Alessandra, AU - Zanin,Renata, AU - Volpe,Annibale, Y1 - 2008/10/16/ PY - 2008/08/01/received PY - 2008/09/02/revised PY - 2008/09/02/accepted PY - 2009/1/13/entrez PY - 2009/1/13/pubmed PY - 2009/4/10/medline SP - 111 EP - 6 JF - Contraception JO - Contraception VL - 79 IS - 2 N2 - BACKGROUND: Second-generation and third-generation oral contraceptives containing 30 mcg or more of ethinylestradiol (EE) decrease insulin sensitivity (SI). In this study, we investigated whether SI is decreased by contraceptives containing lower doses EE or by progestins with antiandrogenic properties. STUDY DESIGN: Twenty-eight young healthy women were randomly allocated to receive 20 mcg of EE and 150 mcg of desogestrel (DSG) (n=14) or 30 mcg of EE and 2 mg of chlormadinone acetate (CMA) (n=14) for 6 months. SI and glucose utilization independent of insulin (Sg) were investigated by the minimal model method. Lipid modifications were also analyzed. RESULTS: SI decreased with EE/DSG (7.09+/-1.4 vs. 4.30+/-0.91; p=.04; n=12), but not with EE/CMA (5.79+/-0.93 vs. 6.79+/-1.1; p=.48; n=12). SI modifications observed in the two groups were significantly different (-2.79+/-1.15 vs. 1.0+/-1.38; p=.05). Sg did not vary with either treatment. The response of C-peptide to glucose increased, but significantly so only with EE/CMA (p=.01). The C-peptide/insulin response increased with both EE/DSG (p=.05) and EE/CMA (p=.04). High-density lipoprotein (HDL) cholesterol (p=.02) and triglycerides (p=.02 and p=.01) increased in both groups, but HDL/low-density lipoprotein cholesterol (p=.02), apoprotein A1 (Apo-A1) (p=.04) and Apo-A1/apoprotein B (p=.048) increased significantly only with EE/CMA. CONCLUSIONS: The present study confirms that DSG, even when associated with low EE dose, decreases SI. By contrast, EE/CMA does not deteriorate SI and induces a favorable lipid profile. SN - 1879-0518 UR - https://www.unboundmedicine.com/medline/citation/19135567/Insulin_sensitivity_and_lipid_metabolism_with_oral_contraceptives_containing_chlormadinone_acetate_or_desogestrel:_a_randomized_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0010-7824(08)00452-6 DB - PRIME DP - Unbound Medicine ER -