Newer oral contraceptives alter inflammatory status of young women
Newer oral contraceptives alter inflammatory status of young womenLast Updated: 2008-04-18 10:28:41 -0400 (Reuters Health)
NEW YORK (Reuters Health) - In young, healthy, normal-weight women, use of third-generation oral contraceptives is associated with elevated levels of high-sensitivity C-reactive protein (CRP), potentially placing these women at higher risk for venous thromboembolism and cardiovascular disease, researchers report in the April issue of Obstetrics and Gynecology.
Third-generation agents containing desogestrel or gestodene were introduced to reduce the adverse effects of oral contraceptives, especially cardiovascular disease, Dr. Sabina Cauci from the University of Udine, Italy, and colleagues note in their report.
\"However, evidence suggests that these preparations do not reduce, but may even increase, the risk of venous thromboembolism compared with previous generations,\" they point out.
To investigate further, Dr. Cauci's team measured levels of high-sensitivity CRP, homocysteine and lipids in 77 users of third-generation oral contraceptives and 200 women of similar age who did not use oral contraceptives. Of the 77 contraceptive users, 24 (31%) were taking pills containing desogestrel and 53 (69%) were taking pills with gestodene.
Levels of high-sensitivity CRP \"posing a high risk of cardiovascular disease\" (that is, 3.0 to less than 10.0 mg/L) were present in significantly more contraceptive users vs nonusers (27.3% vs 8.5%; odds ratio 4.04).
Moreover, levels of CRP posing an intermediate risk (1.0 to less than 3.0 mg/L) were present in 32.5% of contraceptive users vs 11.0% of nonusers -- an odds ratio of 3.85.
Use of third-generation contraceptives did not affect homocysteine levels, according to the investigators, and seemed to have a beneficial effect on the cholesterol profile in young women, although it caused triglyceride elevations.
\"Our study showed that many young, healthy, normal-weight oral contraceptive users have elevated concentrations of high-sensitivity CRP and thus they are potentially at higher cardiovascular disease risk than nonusers,\" Dr. Cauci's team writes. They add, \"Because this low-grade inflammatory condition is asymptomatic, it is not normally recognized and/or investigated.\"
Obstet Gynecol 2008;111:857-864.
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