Fertility and sterility · 2011
Divergent effects of a combined hormonal oral contraceptive on insulin sensitivity in lean versus obese women.
Клиническое исследованиеСравнительное исследованиеСтатьяПоддержка NIH: внешняя программаПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Cheang Kai I, Essah Paulina A, Sharma Susmeeta, Wickham Edmond P, Nestler John E
Аннотация
OBJECTIVE: To evaluate the effects of a commonly used combined hormonal oral contraceptive (OC) on carbohydrate metabolism in obese as compared with lean women.
DESIGN: 6-month prospective study.
SETTING: Clinical research center at an academic medical center.
PATIENT(S): Premenopausal nondiabetic women with body mass index <25 kg/m(2) (n = 15) or >30 kg/m(2) (n = 14).
INTERVENTION(S): Ethinyl estradiol (35 μg) and norgestimate (0.18/0.215/0.25 mg) for 6 cycles.
MAIN OUTCOME MEASURE(S): Insulin sensitivity by frequent sampling intravenous glucose tolerance test; other indices of insulin sensitivity (homeostatic model assessment of insulin sensitivity index [ISI HOMA], the Matsuda index); fasting lipid panel.
RESULT(S): Insulin sensitivity changed from 6.62 ± 3.69 min(-1)/mIU/L (baseline) to 8.23 ± 3.30 min(-1)/mIU/L (6 months) in lean women, and from 4.36 ± 2.32 to 3.82 ± 2.32 min(-1)/mIU/L in obese women. Divergent effects on insulin sensitivity were also observed with ISI HOMA and the Matsuda index. Low-density lipoprotein increased by approximately 20 mg/dL in both the lean and obese groups.
CONCLUSION(S): Lean and obese women exhibit differential changes in insulin sensitivity when given 6 months of a commonly used oral contraceptive. The mechanisms of these differences and whether these divergent effects persist in the long term require further investigation.
DESIGN: 6-month prospective study.
SETTING: Clinical research center at an academic medical center.
PATIENT(S): Premenopausal nondiabetic women with body mass index <25 kg/m(2) (n = 15) or >30 kg/m(2) (n = 14).
INTERVENTION(S): Ethinyl estradiol (35 μg) and norgestimate (0.18/0.215/0.25 mg) for 6 cycles.
MAIN OUTCOME MEASURE(S): Insulin sensitivity by frequent sampling intravenous glucose tolerance test; other indices of insulin sensitivity (homeostatic model assessment of insulin sensitivity index [ISI HOMA], the Matsuda index); fasting lipid panel.
RESULT(S): Insulin sensitivity changed from 6.62 ± 3.69 min(-1)/mIU/L (baseline) to 8.23 ± 3.30 min(-1)/mIU/L (6 months) in lean women, and from 4.36 ± 2.32 to 3.82 ± 2.32 min(-1)/mIU/L in obese women. Divergent effects on insulin sensitivity were also observed with ISI HOMA and the Matsuda index. Low-density lipoprotein increased by approximately 20 mg/dL in both the lean and obese groups.
CONCLUSION(S): Lean and obese women exhibit differential changes in insulin sensitivity when given 6 months of a commonly used oral contraceptive. The mechanisms of these differences and whether these divergent effects persist in the long term require further investigation.
Предметные рубрики MeSH
Academic Medical CentersAdultAnalysis of VarianceBlood GlucoseBlood PressureBody Mass IndexContraceptives, Oral, CombinedContraceptives, Oral, HormonalDrug Administration ScheduleDrug CombinationsEthinyl EstradiolFemaleGlucose Tolerance TestHumansInsulinInsulin ResistanceLipoproteins, LDLNorgestrelObesityProspective StudiesThinnessTime FactorsVirginiaYoung Adult