Long-Term Effects of Depot-Medroxyprogesterone Acetate on Lipoprotein Metabolism

Garza-Flores, J.; Cruz, D. L. De La; Bourges, V. Vales De; Sanchez-Nuncio, B.; Martínez, Marco Antonio Olivera; Fuziwara, J.L.; Pérez‐Palacios, Gregorio

doi:10.1097/00006254-199201000-00027

Cited by 3 publications

(4 citation statements)

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“…However there were non significant changes in mean serum TC, HDL, LDL and AI among DMPA users in comparison to the non users after 6 and 12 months nor in relation to the duration of use. This is in agreement with the study of Garza-Flores et al, (27) who found that the use of DMPA for 5 years causes a moderate increase in the serum TG, but a moderate non significant decrease in TC and HDL, with unchanged LDL. Fahmy et al, (28) found that after 3 months use of DMPA, there were no significant changes in TC and TG, while there was a significant decrease in HDL, and a significant increase in LDL.…”

Section: Discussionsupporting

confidence: 93%

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

Al-Youzbaki¹

2011

Ann Coll Med Mosul

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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.

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Section: Discussionsupporting

confidence: 93%

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

Al-Youzbaki¹

2011

Ann Coll Med Mosul

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“…This finding indicates that DMPA may alter the reverse cholesterol transport. As mentioned above, previous studies reported inconsistent results regarding the lipid metabolism alteration by DMPA treatment [3,4]. In the present study, low and medium doses of the green tea extract significantly prevented DMPAinduced increase in LDL-c levels, but can't reach the level of the untreated control group.…”

Section: Discussioncontrasting

confidence: 52%

“…In another study, DMPA significantly decreased HDL-c compared with the control group [2]. Other study compared the new acceptors and chronic users of DMPA: a moderate increase in serum total triglyceride at the expense of the very low density lipoprotein (VLDL) fraction was reported in the group of chronic DMPA users; in new acceptors DMPA insignificantly decreased total cholesterol and HDL-c [3]. After 3 months of DMPA treatment, the HDL-c levels significantly decreased and a significant increase in LDL-c, but no change in total lipids, total cholesterol and triglycerides were reported.…”

Section: Introductionmentioning

confidence: 97%

Cholesterol/HDL-c ratio lowering effect of green tea in rats exposed to depot medroxiprogesterone acetate

Susilawati¹,

Barlıanto²,

Wiyasa³

2015

J Exp Integr Med

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Objective: This study aimed to investigate whether an extract of green tea is able to decrease low density lipoproteincholesterol (LDL-c) and increase high density lipoprotein (HDL)-c in rats exposed to depot medroxyprogesterone acetate (DMPA). Methods: Twenty five female Wistar rats were divided into five groups (n = 5 each): (1) untreated negative control; (2) positive control which received DMPA only; (3) DMPA plus green tea extract at the dose of 10.8 mg/kg/day; (4) DMPA plus green tea extract at the dose of 21.6 mg/kg/day; (5) and DMPA plus green tea extract at the dose of 43.2 mg/kg/day. The treatment with green tea was performed for four weeks. Serum lipid profile and atherogenic index were analyzed by automated enzymatic technique. Results: DMPA significantly changed the serum lipid profile marked by decreased HDL, increased LDL and cholesterol/HDL-c ratio compared with the untreated group. The increase in LDL was significantly attenuated by all treatment doses of of green tea. Similarly, the decrease in HDL level was significantly attenuated by all doses of the extract. On the other hand, increased levels of cholesterol/HDL-c ratio in the DMPA group was significantly reduced by lowest and highest doses of green tea extract. Conclusion: Green tea extract inhibits the increase in LDL-c and cholesterol/HDL-c ratio induced by DMPA. This may provide a natural therapeutic alternative for normalizing the lipid profile found in subjects exposed to DMPA.

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“…Estrogens may also alter lipoprotein lipase activity, shifting the flux of triglycerides from storage in adipose tissue to usage in skeletal muscle 73 . Progestins also can contribute to this dysregulation: desogestrel and gestodene are associated with elevations in triglycerides, as is DMPA 74 . Levonorgestrel implants, however, reduce triglyceride concentrations in a dose‐dependent manner 72 …”

Section: Hormonal Contraception and Metabolic Dysregulationmentioning

confidence: 99%

Hormonal Contraception and HIV‐Positive Women: Metabolic Concerns and Management Strategies

Womack¹,

Richman²,

Tien³

et al. 2008

J Midwife Womens Health

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As HIV-positive women live longer lives, and as testing for HIV becomes more routine, clinicians can expect to see more HIV-positive women in their practices. The need to be aware of management issues particular to this population becomes increasingly important. Metabolic dysregulation is a common, long-term complication associated with HIV and is one of the most difficult to manage. Hormonal contraception also is associated with metabolic dysregulation. As more HIV-positive women choose long-term, reversible contraception, the potential for concomitant and additive side effects, and the need for careful, proactive management strategies to avoid these complications, will become more important. This article reviews research detailing the metabolic dysfunction associated with hormonal contraception and with HIV-seropositivity. It highlights reasons for concern regarding the potential, although as yet theoretical, increased risk for metabolic dysfunction when hormonal contraception is used in the presence of HIV. Suggestions for management strategies for women living with HIV who choose to use hormonal contraception are presented. These strategies should be viewed as suggestions for management until substantitive research becomes available.

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Long-Term Effects of Depot-Medroxyprogesterone Acetate on Lipoprotein Metabolism

Cited by 3 publications

References 0 publications

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

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

Cholesterol/HDL-c ratio lowering effect of green tea in rats exposed to depot medroxiprogesterone acetate

Hormonal Contraception and HIV‐Positive Women: Metabolic Concerns and Management Strategies

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