Effects of Second and Third Generation Oral Contraceptives on Lipid and Carbohydrate Metabolism in Overweight and ObeseWomen: A Randomized Triple-Blind Controlled Trial
نویسندگان
1 Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran
2 Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran
3 Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran
4 Department of Midwifery, Nursing and Midwifery Faculty, Tabriz Health Services Management Research Centre, Tabriz University of Medical Sciences, Tabriz, IR Iran
doi
چکیده
Combined oral contraceptives (COCs) have not been shown to have major effects on lipid and carbohydratemetabolism in normal-weight women. However, we have limited information about the effects on women at high risk for cardiovasculardisease and diabetes due to being overweight and obese.Objectives: To evaluate the effects of second and third generation contraceptive pills on lipid and carbohydrate metabolism inoverweight and obese women.Patients and Methods: This triple-blind controlled trial was performed on 137 healthy women aged 18 - 40 years with a body massindex of 25-34.9 (kg/m2) who were referred to health centers in Tabriz, Iran from 2014 to 2015. The women were randomly dividedinto groups who were to take 30 mcg ethinyl estradiol/150 mcg levonorgestrel (EE/LGN) (n = 69) or 30 mcg ethinyl estradiol/150 mcgdesogestrel (EE/DSG) (n = 68) with an allocation ratio of 1: 1 for three cycles. As primary outcomes, high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol (LDL-C), and fasting plasma glucose (FPG) were assessed; total cholesterol (TC),triglycerides (TG), and 2-hour plasma glucose in the 75-g oral glucose tolerance test (2-hour 75-g OGTT) were assessed as secondaryoutcomes.Results: The differences in lipid and carbohydrate parameters were not significant between the two groups, except for HDL-C (AdjustedMD(CI95%) = 7.00 (2.98 to 11.02)). HDL-C decreased with EE/LGN (P = 0.016) and increased with EE/DSG (P = 0.004). LDL-C and TCincreased in both groups, whereas TG increased only with EE/DSG (P < 0.05). Compared with the baseline, FPG levels did not differsignificantly in both groups, but EE/DSG increased 2-hour 75-g OGTT (P = 0.010).Conclusions:We observednosignificant differencesbetween thetwogroups in lipidandcarbohydrate metabolism, except for HDLC.Considering the importance of overweight and obese women’s health, studies with longer follow-up periods are recommendedin this respect.
