Effects of second and third generation oral contraceptives on lipid and carbohydrate metabolism in overweight and obese women : a randomized triple-blind controlled trial

Abstract EN

Background : Combined oral contraceptives (COCs) have not been shown to have major effects on lipid and carbohydrate metabolism in normal-weight women.

However, we have limited information about the effects on women at high risk for cardiovascular disease and diabetes due to being overweight and obese.

Objectives : To evaluate the effects of second and third generation contraceptive pills on lipid and carbohydrate metabolism in overweight and obese women.

Patients and Methods : This triple-blind controlled trial was performed on 137 healthy women aged 18 - 40 years with a body mass index of 25-34.9 (kg/m2) who were referred to health centers in Tabriz, Iran from 2014 to 2015.

The women were randomly divided into groups who were to take 30 mcg ethinyl estradiol/150 mcg levonorgestrel (EE/LGN) (n = 69) or 30 mcg ethinyl estradiol/150 mcg desogestrel (EE/DSG) (n = 68) with an allocation ratio of 1: 1 for three cycles.

As primary outcomes, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and fasting plasma glucose (FPG) were assessed; total cholesterol (TC), triglycerides (TG), and 2-hour plasma glucose in the 75-g oral glucose tolerance test (2-hour 75-g OGTT) were assessed as secondary outcomes.

Results : The differences in lipid and carbohydrate parameters were not significant between the two groups, except for HDL-C (AdjustedMD( CI95 %) = 7.00 (2.98 to 11.02)).

HDL-C decreased with EE/LGN (P = 0.016) and increased with EE / DSG (P = 0.004).

LDL-C and TC increased in both groups, whereas TG increased only with EE/DSG (P < 0.05).

Compared with the baseline, FPG levels did not differ significantly in both groups, but EE / DSG increased 2-hour 75-g OGTT (P = 0.010).

Conclusions:We observednosignificant differencesbetween thetwogroups in lipidandcarbohydrate metabolism, except for HDLC.

Considering the importance of overweight and obese women’s health, studies with longer follow-up periods are recommended in this respect.