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  • Title: Fasting plasma lipids, lipoproteins and apolipoproteins in Nigerian women using combined oral and progestin-only injectable contraceptives.
    Author: Oyelola OO.
    Journal: Contraception; 1993 May; 47(5):445-54. PubMed ID: 8513671.
    Abstract:
    Fasting plasma lipid, lipoprotein, and apolipoprotein (apo) profiles were determined in Nigerian women using a low-dose combined oral (Lo-Feminal + Fe) (n = 18), a progestin-only injectable (Depo-Provera) (n = 16) contraceptives and matched controls (n = 18). The mean of plasma total and low-density lipoprotein (LDL) cholesterol, apo B and Lp(a) were significantly higher (p < 0.01) in women using contraceptives than the controls. The mean of total and LDL-cholesterol and apo B were also significantly higher in the oral contraceptive users than those on progestin-only injectables. Furthermore, the mean of cardiovascular disease (CVD) risk indices, total/HDL-cholesterol (p < 0.05) and LDL/HDL-cholesterol (p < 0.01), were significantly higher in women on oral contraceptives than the controls. There were no statistically significant differences between the indices in the women using progestin-only injectables and the controls. Based on this finding, it is concluded that the use of steroidal contraceptives is associated with alterations of lipid and apolipoprotein profiles in Nigerian women and that the use of low-dose combined oral contraceptives may be associated with an increased CVD risk. Fasting plasma cholesterol, triglycerides, lipoprotein profiles, and apolipoprotein fractions were assayed in 18 Nigerian women taking low-dose, combined oral contraceptive (OC), 16 using an injectable progestin, and in 18 controls. The OC, Lo-Feminal + Fe, contained 30 mcg ethinyl estradiol and 0.3 mg norgestrel, with 7 placebos of 75 mg ferrous fumarate. Depo-Provera (150 mg medroxyprogesterone acetate) was the injectable. Lipids and HDL-cholesterol were determined on a Hitachi 737 automated chemistry analyzer, and apolipoproteins were assayed by ELISA or electroimmunoassay. Total cholesterol, low-density cholesterol (LDL), apo B, and Lp(a) were significantly higher in OC users than in controls, and total cholesterol, LDL, and apo B were also significantly higher in OC users than in injectable users. Cardiovascular disease risk ratios, calculated as total cholesterol/HDL, were significantly higher in OC users than in controls, but these ratios did not differ between injectable users and controls. While LDL and the atherogenic lipoproteins apo B and Lp(a) were higher in these OC users, it is likely that other factors need to be considered, such as age, smoking, blood pressure, and glucose tolerance, to estimate the overall risk of cardiovascular disease for Nigerian OC users.
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