Effects of desogestrel and gestodene in low-dose oral contraceptive combinations on lipid and lipoprotein status. A randomized prospective study.

ABSTRACT

This study was designated to assess the effects of two low-dose oral contraceptives (OC) on serum lipids and lipoproteins and to compare, at same oestrogen dose (30 micrograms), the effects of desogestrel (DG) with those of a new progestin, gestodene (GD). Fifty-four young women, matched for Quetelet's Index, age, diet, alcohol consumption, smoking and exercise habits, were randomly assigned to one of two regimens. Serum high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, total triglycerides (T) and cholesterol (C), apolipoprotein A-1 (Apo A) and apolipoprotein B (Apo B) were measured prior to the OC commencement and after 6-cycle treatment. Sex hormone binding globulin (SHRG) and ceruloplasmin (CP) were determined as well. LDL-C, Apo A, C, T, increased significantly from baseline values, being still the increase within the reference range. Apo B changed proportional to the LDL-C increase. A rise in HDL-C occurred but it was statistically significant in the EE-DG group only. This result would suggest that the EE-DG combination is more estrogen-dominant that the EE-GD combination. However, this hypothesis was not consistent with the increase to the similar extent for SHBG and CP, which reflect the estrogenicity/gestagenicity of the two OCs. The disproportion of change between HDL-C and Apo A in only EE-GD group might reflect some compositional change in HDL particle. There were no significant differences between the two formulations for the parameters investigated.

ABSTRACT

PIP This study was designed to assess the effects of 2 low-dose oral contraceptives (OCs) on serum lipids and lipoproteins and to compare, at the same 30 mcg estrogen dose, the effects of desogestrel (DG) with those of a new progestin, gestodene (GD). 54 young women, matched for Quetelet's Index, age, diet, alcohol consumption, smoking, and exercise habits, were randomly assigned to 1 of 2 regimens. Serum high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL), cholesterol, total triglycerides (T), and cholesterol (C), apolipoprotein A-1 (Apo A), and Apo B were measured prior to the OC commencement and after 6 cycles of treatment. Sex hormone binding globulin (SHBG) and ceruloplasmin (CP) were determined as well. LDL-C, Apo A, C, and T increased significantly from baseline values, still remaining within the reference range. Apo B changed proportionally to the LDL-C increase. A rise in HDL-C occurred but it was statistically significant in the EE-DG group only. This result would suggest that the EE-DG combination is more estrogen dominant than the EE-GD combination; however this was not consistent with the increase to a similar extent of SHBG and CP, which reflect the estrogenicity/gestagenicity of the 2 OCs. The disproportionate change between HDL-C and Apo A in only the EE-GD group might reflect some compositional change in HDL particles. There were no significant differences between the 2 formulations for the parameters investigated.