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  • Title: A comparison of the effects of NORPLANT capsules and NORPLANT-2 rods on clinical chemistry: metabolic changes.
    Author: Singh K, Viegas OA, Ratnam SS.
    Journal: Ann Acad Med Singap; 1990 Nov; 19(6):833-6. PubMed ID: 2130749.
    Abstract:
    A comparison of the effects of NORPLANT capsules and NORPLANT-2 rods on liver function, lipid and carbohydrate metabolism is presented. The results indicate that the effects of both these long acting progestogen-containing subdermal implant systems are similar and comparable. With respect to liver function, possible hepatocellular dysfunction is indicated as evidenced by a significant rise in serum bilirubin and a significant fall in total protein and globulin. As regards to lipid metabolism, there appears to be no cardiovascular risk in both groups. The effects of NORPLANT on carbohydrate metabolism is not of any clinical significance. Medical researchers enrolled 100 women who use the NORPLANT 6 capsule system and 100 women who used the NORPLANT 2 rod system in a clinical trial at the National University Hospital in Singapore to compare the 2 implants' effects on clinical chemistry. The mean bilirubin levels increased 55% during the 1st year for both groups. These levels fell a mere 4.5% in the NORPLANT-2 group. Still, at the end of 2 years, the mean bilirubin levels of both groups were significantly higher than preinsertion levels. Total proteins and globulins fell significantly in both groups during the 2 year study. The mean albumin level rose significantly in the NORPLANT-2 women and the slight risk in NORPLANT-6 women was not significant. Even though these changes in liver function occurred, the mean levels of bilirubin, total protein, globulin, and albumin stayed within the normal clinical range. Further no individual had levels outside the normal range. NORPLANT-6 and NORPLANT-2 had basically similar effects on lipid metabolism. The high density lipoprotein (HDL) cholesterol/total cholesterol ratio was .200 for both groups indicating that the 2 NORPLANT systems did not put women at increased risk of coronary heart disease. In addition, the low density lipoprotein cholesterol/HDL ratio for both groups did not rise higher that the preinsertion level. These results indicated that the 2 systems may actually have a protective effect against cardiovascular conditions in the 1st 2 years. Neither NORPLANT-6 nor NORPLANT-2 significantly changed carbohydrate metabolism. At the end of 1 hour, however, the glucose tolerance levels significantly increased, but fell considerably at 2 hours. In fact, absolute glucose tolerance levels stayed in the normal range. In conclusion, the 2 systems acted essentially the same.
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