Estradiol valerate in COC has more favorable inflammatory profile than synthetic ethinyl estradiol : a randomized trial
Kangasniemi, Marika H.; Haverinen, Annina; Luiro, Kaisu; Hiltunen, J. Kalervo; Komsi, Elina K.; Arffman, Riikka K.; Heikinheimo, Oskari; Tapanainen, Juha S.; Piltonen, Terhi T. (2020-04-18)
Marika H Kangasniemi, Annina Haverinen, Kaisu Luiro, J Kalervo Hiltunen, Elina K Komsi, Riikka K Arffman, Oskari Heikinheimo, Juha S Tapanainen, Terhi T Piltonen, Estradiol Valerate in COC Has More Favorable Inflammatory Profile Than Synthetic Ethinyl Estradiol: A Randomized Trial, The Journal of Clinical Endocrinology & Metabolism, Volume 105, Issue 7, July 2020, Pages e2483–e2490, https://doi.org/10.1210/clinem/dgaa186
© Endocrine Society 2020. The final authenticated version is available online at https://doi.org/10.1210/clinem/dgaa186.
https://rightsstatements.org/vocab/InC/1.0/
https://urn.fi/URN:NBN:fi-fe2021113058010
Tiivistelmä
Abstract
Context: Combined oral contraceptives (COCs) alter inflammatory status and lipid metabolism. Whether different estrogens have different effects is poorly understood.
Objective: We compared the effects of COCs containing ethinyl estradiol (EE) or estradiol valerate (EV) and dienogest (DNG) with those containing DNG only on inflammation and lipid metabolism.
Design: Randomized, controlled, open-label clinical trial.
Setting: Two-center study in Helsinki and Oulu University Hospitals.
Participants: Fifty-nine healthy, young, nonsmoking women with regular menstrual cycles. Age, body mass index, and waist-to-hip ratio were comparable in all study groups at the beginning. Fifty-six women completed the study (EV + DNG, n = 20; EE + DNG, n = 19; DNG only, n = 17).
Interventions: Nine-week continuous use of COCs containing either EV + DNG or EE + DNG, or DNG only as control.
Main Outcome Measures: Parameters of chronic inflammation (high-sensitivity C-reactive protein [hs-CRP], and pentraxin 3 [PTX-3]) and lipid profile (high-density lipoprotein [HDL], low-density lipoprotein [LDL], triglycerides, and total cholesterol).
Results: Serum hs-CRP increased after 9-week use of EE + DNG (mean change ± standard deviation 1.10 ± 2.11 mg/L) compared with EV + DNG (−0.06 ± 0.97 mg/L, P = 0.001) or DNG only (0.13 ± 0.68 mg/L, P = 0.021). Also, PTX-3 increased in the EE + DNG group compared with EV + DNG and DNG-only groups (P = 0.017 and P = 0.003, respectively). In the EE + DNG group, HDL and triglycerides increased compared with other groups (HDL: EE + DNG 0.20 ± 0.24 mmol/L vs EV + DNG 0.02 ± 0.20 mmol/L [P = 0.002] vs DNG 0.02 ± 0.18 mmol/L [P = 0.002]; triglycerides: EE + DNG 0.45 ± 0.21 mmol/L vs EV + DNG 0.18 ± 0.36 mmol/L [P = 0.003] vs DNG 0.06 ± 0.18 mmol/L [P < 0.001]).
Conclusions: EV + DNG and DNG only had a neutral effect on inflammation and lipids, while EE + DNG increased both hs-CRP and PTX-3 levels as well as triglycerides and HDL.
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