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Lipid and Lipoprotein Changes Associated With Oral Contraceptive Use: A Randomized Clinical Trial

BURKMAN, RONALD T. MD; ROBINSON, J COURTLAND MD; KRUSZON-MORAN, DEANNA MS; KIMBALL, ALLYN W. PhD; KWITEROVICH, PETER MD; BURFORD, ROBERT G. PhD
Obstetrics & Gynecology: January 1988
Original Article: PDF Only

To determine the effects of oral contraceptives on lipids and Iipoproteins over a six-month period, we randomized 266 women into four oral contraceptive groups: ethinyl estradiol 35 µ/g plus ethynodiol diacetate 1 mg, ethinyl estradiol 30 µg plus levonorgestrel 0.15 mg, ethinyl estradiol 35 µg plus norethindrone 1 mg, and ethinyl estradiol 35 fig plus norethindrone 0.5 and 1 mg (biphasic). For all groups, total cholesterol increased 5.9-9.1% from baseline values over the six months. Triglycerides increased with all preparations, with the ethynodiol diacetate group (37.6%) and the biphasic norethindrone group (45.3%) showing the greatest increase. Low-density lipoprotein cholesterol increased 10-15.6% among the groups; low-density lipoproteinapolipoprotein B changed proportional to the low-density lipoprotein cholesterol increases. All groups except the ethynodiol diacetate group showed a decrease of highdensity lipoprotein cholesterol, with the levonorgestrel group (8.7%) and biphasic norethindrone group (4.5%) showing the largest declines. Apolipoprotein A-l increased in all groups, with the ethynodiol diacetate preparation (19.3%) showing the greatest increase and the levonorgestrel preparation (3.2%) showing the smallest increase from baseline values. The changes in apolipoprotein A-l were out of proportion to the changes in high-density lipoprotein cholesterol, suggesting that the high-density lipoprotein particle may be undergoing some type of metabolic alteration.

© 1988 The American College of Obstetricians and Gynecologists