C-reactive protein and lipid profile among depot- medroxyprogesterone acetate injections users

Abstract

Objective:To study the effect of depot-medroxyprogesterone acetate (DMPA) injections on Creactive protein (CRP) and lipid profile and to find the predictors (body weight, body mass index (BMI), blood pressure (BP) and lipid profile) that significantly predict the risk of cardiovascular disease (CVD) among DMPA injections users. Method: A prospective cohort study was performed during the period from March 2009 to March 2010 included thirty apparently healthy married women, their age ranged between 20-35 years, who were attending Al-Batool and Al-Khansa Family Planning Centers in Mosul and started (for the first time) to use DMPA injections (150 mg medroxyprogesterone acetate), called "Depo-Provera" as contraceptive. These (DMPA users group) were compared to another 30 healthy married women who did not use any hormonal contraceptives (non users group). Both groups were followed for one year, during which blood samples were obtained from both groups, before starting to use DMPA, after 6 months and after 12 months. Sera were used for the estimation of the biochemical studied parameters using commercial kits except serum low density lipoprotein (LDL) and atherogenic index (AI) which were calculated by special equations. Results: DMPA injections caused a non significant increase in body weight but a significant increase in BMI after 12 months. There was a significant increase in the mean diastolic blood pressure (DBP) of DMPA users according to the duration of use. The DMPA caused non significant changes in the CRP levels. There was a significant increase in serum triglycerides (TG) after 6 months of DMPA uses with respect to the duration of use. But there were non significant changes in mean serum total cholesterol (TC), high density lipoprotein (HDL), LDL and AI. Among all variables that were studied, only body weight and BMI showed a significant positive correlations with CRP. Using a stepwise multiple regression analysis, it was found that the predictors that significantly predict the risk of CVD among DMPA users were AI, DBP and TG. Conclusion: This study found that there is a significant positive association between CRP and CVD risk factors in DMPA injections users as contraceptive. Furthermore AI, DBP and TG were found to be significant predictors for the risk of CVD among DMPA users. This study confirmed the safety of DMPA use as contraceptive medication, but that special care should be directed for patients with CVD and other patients who were more sensitive to the harmful effects of lipid in the blood.

Changes in body weight and blood pressure among women using Depo-Provera injection in Northwest Ethiopia

“…Moreover, a recent study conducted to assess dietary intake and weight gain among adolescents on Depo-Provera, demonstrated that mean BMI increased significantly from 23.7 ± 5.3 at the baseline to 25.3 ± 5.7 after 12 months of using of Depo-Provera with increased mean percentage body fat significantly [14]. While other studies indicated Depo-Provera users pose increased body weight in comparison to their controls, however, changes were not statistically significant [6]. This could be due to the difference in race/ethnicity, which is associated with weight gain, where black women had a greater mean weight gain compared to white, Bushmen, oriental and Papuan with continued Depo-Provera use [9, 16].…”

“…Depo-Provera is among a highly effective, convenient non-daily injectable hormonal contraceptive option with a very low failure rate that has been available worldwide for many years. The recommended dose of this contraceptive is 150 mg, administered by deep intramuscular (IM) injection at the interval of 3 months using strict aseptic technique in the gluteal or deltoid muscle [6, 7]. Side effects of this contraceptive method include: changes in menstrual patterns, loss of bone mineral density and risk of weight gain.…”

“…Prior studies have demonstrated the association between Depo-Provera with both weight gain [8, 9] and blood pressure [10]. On the other hand, another study reported that Depo-Provera injections did not cause a significant increase in body weight and blood pressure [6]. Since the previous studies performed among different ethnic groups showed diverse results and available data on this topic which are mostly from developed countries, this study was aimed to investigate the effects of Depo-Provera on body weight and blood pressure among Ethiopian women.…”

Differences of lipid profile, body fat percentage, and waist circumference between childbearing age women acceptors of depot medroxy progesterone acetate contraceptive injection with non-acceptors in Padang City 2017

“…5 In theory, progesterone also stimulates the appetite control center in the hypothalamus by activating neuropeptide Y, resulting an increase in appetite which will affect the percentage of body fat, body mass index, and waist circumference of its users. 6,7 The research conducted by Youzbaki (2011) in Iraq regarding lipid profiles in 30 subjects using DMPA showed higher mean triglyceride levels in DMPA acceptors, namely (170.26±58.74) mg/dl than non DMPA acceptors, namely (147.74±74.76) mg/dl with p = 0.226 (p>0.05), which means that there were no statistically significant differences in the two groups. 8 Research conducted by Gisele (2017) in Brazil showed that the mean BMI of DMPA acceptor group was higher (24.88±3.43) than the IUD acceptor group, namely (24.56±2.84) with p value = 0.007 which means that there was a difference in BMI between DMPA and IUD acceptor.…”

“…6,7 The research conducted by Youzbaki (2011) in Iraq regarding lipid profiles in 30 subjects using DMPA showed higher mean triglyceride levels in DMPA acceptors, namely (170.26±58.74) mg/dl than non DMPA acceptors, namely (147.74±74.76) mg/dl with p = 0.226 (p>0.05), which means that there were no statistically significant differences in the two groups. 8 Research conducted by Gisele (2017) in Brazil showed that the mean BMI of DMPA acceptor group was higher (24.88±3.43) than the IUD acceptor group, namely (24.56±2.84) with p value = 0.007 which means that there was a difference in BMI between DMPA and IUD acceptor. 9 Research conducted by Bonny (2009) stated that most DMPA acceptor fat percentage was 20-30% with body mass index ranged from 18.5 to 24.9, showing p value <0.05, which means that there was no difference in DMPA users with fat percentage and body mass index.…”