The effects of different formulations of oral contraceptive agents on lipid and carbohydrate metabolism

Godsland, IF; Crook, David; Simpson, R. W.; T, Proudler; Felton, Carl V.; Lees, Belinda; Anyaoku, V.; Devenport, M; Wynn, V.

doi:10.1016/0020-7292(91)90218-t

Cited by 73 publications

(105 citation statements)

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“…Oestrogen-induced changes in glycaemia and insulin sensitivity The most consistent effect of oral contraceptives and oestrogen replacement therapy is to lower fasting plasma glucose and to worsen glucose tolerance [2,3,6,28,46], also seen in the NHANES studies [47]. Basal insulin is unchanged or reduced, whereas glucose-stimulated insulin is enhanced.…”

Section: Oestrogen-induced Changes In Growth Hormonementioning

confidence: 99%

“…This dates back to the 1960s, when glucose tolerance was seen to deteriorate in women on high-oestrogen oral contraceptives [1], some of whom developed a reduced early insulin response to glucose and diabetic plasma glucose levels [2]. Worsening glucose tolerance was confirmed with low-dose oral contraceptive use [3] and, depending on steroid composition and dose, postmenopausal oestrogen hormone replacement therapy (HRT) [4]. Accordingly, there is a persistent perception that oestrogens have an adverse effect on carbohydrate metabolism, and a corresponding increase in the incidence of diabetes might therefore be expected from their use.…”

Section: Introductionmentioning

confidence: 99%

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Oestrogens and insulin secretion

2005

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There is a persistent perception that oestrogens have an adverse effect on carbohydrate metabolism. It might therefore be expected that their use would result in a corresponding increase in the incidence of diabetes. Recent evidence from clinical trials suggesting that women on postmenopausal oestrogen hormone replacement therapy (HRT) have a reduced incidence of type 2 diabetes therefore appears paradoxical. Short-term supraphysiological oestrogen administration has an adverse effect on glucose tolerance, resulting from suppression of first-phase insulin secretion and increased insulin resistance. Oestrogen-induced increases in glucocorticoid activity could account for these effects. Oestrogen-induced deterioration in glucose tolerance is, however, accompanied by a reduction in fasting glucose, an effect that could be accounted for by glucagon antagonism. These short-term effects contrast with long-term preservation of insulin secretion and glucose homeostasis by oestrogens. In animal studies, ovariectomy is associated with decreased insulin secretion and increased risk of diabetes, whereas oestrogen administration protects against diabetes and increases the insulin response to glucose. The mechanism is uncertain, but direct effects on the pancreas via steroid receptors or indirect effects via oestrogen-induced glucagon antagonism and subclinical increases in glucocorticoids and growth hormone could all contribute. Recent evidence that HRT increases the risk of cardiovascular disease suggests that it should not be used for the prevention of diabetes, but the mechanism responsible for this benefit merits further investigation and might lead to new therapies.

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Section: Oestrogen-induced Changes In Growth Hormonementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Oestrogens and insulin secretion

2005

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“…High-dose OC can have significant adverse effects on lipids too, and as in cases of glucose metabolism, is related to the androgenic potency of progestin and its dose. 3 The effect of medroxyprogesterone acetate on plasma lipids has been inconsistent. In general, however, it is associated with a modest reduction in total cholesterol (TC) and triglyceride (TG), slight reduction in high-density lipoprotein cholesterol (HDL-C) and slight increase in low-density lipoprotein cholesterol (LDL-C) levels.…”

mentioning

confidence: 99%

A Comparative Analysis of Three Methods of Contraception: Effects on Blood Glucose and Serum Lipid Profiles

et al. 1999

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“…Such contraceptive use was associated with an increase in 16X0 (both plasma and RBC), plasma total saturates and plasma n-6 LCPUFA and a decrease in both plasma and RBC 20X5n-3 and plasma total PUFA. Hormonal contraception is known to be associated with altered plasma lipid pro®les (Godsland et al, 1990); our results are expressed as a percentage of fatty acids of total lipids and may therefore be independent of any effect of exogenous sex steroids on plasma lipid pro®les. Our report of the potential adverse effects of hormonal contraception on fatty acid status by increasing some saturated fatty acids and decreasing other unsaturated fatty acids is in keeping with earlier work by Aznar et al (1986), although in this smaller study fatty acids were measured in plasma and platelets but not in red cells.…”

Section: Fatty Acid Status C Berry Et Almentioning

confidence: 94%

Fatty acid status of women of reproductive age

et al. 2001

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Objective: Healthy foetal and infant development is dependent on an adequate maternal supply of essential and polyunsaturated fatty acids (PUFA). While there are published data on the fatty acid status of pregnant women, there are few on the status of non-pregnant women of reproductive age. The aims of this study were to test the hypotheses that the fatty acid status of non-pregnant women is affected by socio-economic status and anthropometric, behavioural and obstetric factors. Design: Observational study Methods: One-hundred and thirty-®ve women of child-bearing age (mean 29.8 y, s.d. 6.92) were invited to provide a blood sample and to answer a questionnaire, of whom 114 were included in the study. Plasma and red cell total fatty acids were measured as their methyl esters by gas chromatography mass spectrometry. Results: On multivariate analyses, use of hormonal contraception was independently associated with lower plasma polyunsaturated fatty acids (difference between means À2.76, 95% con®dence interval (À4.64, À0.88), P 0.0034), whereas cigarette smoking was associated with higher red cell oleic acid (0.74 (0.18, 1.29), P 0.0094). Fish intake was associated with higher red cell total n-3 fatty acids (0.62 (0.27, 0.85), P 0.0014). Conclusions:We have reported data on the range of the fatty acids of plasma and red blood cells (RBC) total lipids of 114 healthy women of reproductive age. These data provide further information on how socio-economic, anthropometric, behavioural and obstetric factors may be relevant to female and nutrition and health.

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The effects of different formulations of oral contraceptive agents on lipid and carbohydrate metabolism

Cited by 73 publications

References 0 publications

Oestrogens and insulin secretion

Oestrogens and insulin secretion

A Comparative Analysis of Three Methods of Contraception: Effects on Blood Glucose and Serum Lipid Profiles

Fatty acid status of women of reproductive age

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