Modification of body composition and metabolism during oral contraceptives containing non-androgenic progestins in association with estradiol or ethinyl estradiol

摘要

Aim: To observe the influence on metabolism and body composition of two oral contraceptives containing non-androgenic progestins in association with estradiol or ethinyl estradiol (EE). Study design: Women on hormonal contraception with estradiol valerate (E2V)/dienogest (DNG) in a quadriphasic regimen (n=16) or 30μg EE/2mg chlormadinone acetate (CMA) (n=16) in a monophasic regimen were evaluated at the third cycle for modifications in lipoproteins, apoproteins and homeostatic model assessment for insulin resistance (HOMA-IR), and at the sixth cycle for body composition and the markers of bone turnover osteocalcin and C-telopeptide X. Results: During E2V/DNG lipoprotein, apoproteins and HOMA-IR remained stable. During EE/CMA, total-cholesterol (p=0.003), high-density lipoprotein (HDL)-cholesterol (p=0.001), triglycerides (p=0.003) Apoprotein-A1 (Apo-A1; p=0.001) and Apo B (p=0.04) increased, low-density lipoprotein/HDL (p=0.039) decreased and total-cholesterol/HDL and Apoprotein-B/Apo-A1 ratio did not vary. HOMA-IR slightly increased from 1.33±0.87 to 1.95±0.88 (p=0.005). There was a reduction of markers of bone metabolism in both groups with no modification of body composition. Conclusions: Administration of E2V/DNG does not influence lipid and glucose metabolism, while mixed effect are exerted by EE/CMA. Both preparations reduce bone metabolism without influencing short-term effect on body composition.