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  • Title: Changes in blood levels of proteinase inhibitors, pregnancy zone protein, steroid carriers and complement factors induced by oral contraceptives.
    Author: Nielsen CH, Poulsen HK, Teisner B, Thorsen P, Hau J, Westergaard JG.
    Journal: Eur J Obstet Gynecol Reprod Biol; 1993 Sep; 51(1):63-71. PubMed ID: 7506680.
    Abstract:
    Three low-dose oral contraceptives Trinordiol, Gynatrol, and Marvelon, containing ethinylestradiol (EE) in combination with triphasic levonorgestrel (LNg), monophasic levonorgestrel, and monophasic desogestrel (DGS), respectively, were given to 65 healthy women, n = 21-22 in each group. Blood levels of antithrombin III (AT III), alpha 2-macroglobulin (alpha 2M) alpha 1-antitrypsin (alpha 1at), complement factors (factor B, C3, C4), pregnancy zone protein (PZP), corticosteroid binding globulin (CBG), sex hormone binding globulin (SHBG) and albumin were measured before treatment and during the first and third treatment cycles. AT III levels decreased and alpha 1at levels increased in all three groups during treatment. alpha 2M increased during cycle 3 in the Trinordiol and Gynatrol groups. CBG, PZP and SHBG levels increased in all 3 groups, the CBG and PZP increase being higher in the Marvelon group than in the Gynatrol group. Increases in SHBG levels were found in the order Marvelon > Trinordiol > Gynatrol. Plasma levels of complement factors B, C3 and C4 remained unchanged. It is concluded that the increase in alpha 1at partly compensates for the fall in AT III, that the rise in PZP presumably enhances fibrinolysis, and that LNg has higher anti-estrogenicity and androgenicity than DSG. Clinicians administered 3 types of oral contraceptives (OCs) to 65 healthy 15-31 year old women attending the Public Family Planning Clinic in Odense, Denmark, to determine the effect of the 3 OCs on enzyme inhibitors, complement factors, and steroid dependent proteins. The OCs were a low-dose monophasic containing ethinyl estradiol (EE) and desogestrel (Marvelon), another low dose monophasic containing EE and levonorgestrel (Gynatrol), and a triphasic containing EE and levonorgestrel (Trinordiol). 21-22 women were assigned to each group. Pretreatment values of the biochemical parameters were not significantly different between the 3 groups. In each group, mean plasma antithrombin III (AT III) levels fell (p .04-.002) and alpha1-antitrypsin (alpha1-at) levels increased (p .0001). Mean plasma levels of alpha2-macroglobulin rose sharply during cycle 3 in the Trinordiol and Gynatrol groups (p .04 and .002, respectively). In all 3 groups, mean serum levels of corticosteroid binding globulin (CBG), pregnancy zone protein (PZP), and sex hormone binding globulin (SHBG) increased significantly (p .03-.0001). The CBG and PZP levels were higher in the women using Marvelon than in those using Gynatrol. The increase in SHBG levels were only significant in the Trinordiol and Marvelon groups, however (p .0001). Mean plasma levels of complement factors B, C3, and C4 and of albumin did not change. Based on these results, the researchers concluded that the increase in alpha1-at only partially offsets the decrease in AT III, that the increase in PZP may intensify fibrinolysis, and that levonorgestrel has greater antiestrogenicity and androgenicity than desogestrel.
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