The Influence of the Levonorgestrel-Releassing Intrauterine System (Lng Ius) on Metabolic Markers in Women with Normal Body Mass and Overweight Women

Abstract

27Summary Introduction. In Latvia, the number of overweight women is increasing, while the rate of cardio vascular disease (CVD) is one of the highest in the European Union. The influence of hormonal contraception on the development of CVD has not been studied in Latvia so far. Aim of the study. A nonrandomized open-label prospective trial of healthy reproductive-age women desiring to use the LNG IUS. Materials and methods. Before starting the use of contraception and six months after starting the use of contraception, the homeostasis model assessment insulin resistant (HOMA-IR) score, insulin sensitivity (HOMA-%S) and β-cell function (HOMA-%B) were calculated using fasting glucose (FG) and C peptide values. There were also determined other cardio-metabolic parameters: total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, triglyceride level, systolic and diastolic blood pressure, and abdominal circumference. Results. Thirty women were involved in the study: seventeen women with a normal body-mass index (BMI) (BMI below 25) and thirteen overweight women (BMI above 25). When using the LNG IUS, the fasting glucose level increased in women with normal body mass, the level of insulin sensitivity decreased in both study groups; C peptide level, β-cell function and insulin resistance increased in both groups, but the changes were not statistically reliable (p>0.05). Conclusion. Although during the study there were determined changes in the FG level, insulin sensitivity, C peptide, β-cell function and insulin resistance parameters, these changes are not clinically significant, and the LNG IUS may be safely used clinically both by women with normal body mass and overweight women. Keywords: Levonorgestrel-releasing intrauterine system, contraception, body mass index, insulin resistance, fasting glucose. ORIGINAL ARTICLEThe Influence of the Levonorgestrel-Releassing Intrauterine System (Lng Ius) on Metabolic Markers in Women with Normal Body Mass and Overweight Women Ineta Vasaraudze*,**, Dace Rezeberga**,***, Renars Erts**, Aivars Lejnieks**,*** *I.Vasaraudze Private Clinic Ltd, Riga, Latvia **Riga Stradins University, Latvia ***Riga East Clinical University Hospital, Riga, Latvia to women like gestational diabetes, pregnancy-inducted hypertension & preeclampsia, polycystic ovarian syndrome (6). Since pregnancy-related complications are more common among obese women than among women with normal body weight, the choice of a safe long-term contraception method is of extreme importance. Long-acting reversible contraceptive methods (LARC) include: the copper containing intrauterine device (IUD), the etonogestrel containing sub-dermal implant (not available in Latvia yet) and the levonorgestrelreleasing intrauterine system (LNG IUS). Both methods available in Latvia are long acting (5-12 years), very effective (Perl index is 0.8 and 0.2 for the typical use in one year, respectively), and there is no evidence of a delay in the return of fertility following the removal of IUDs or LNG IUS.A...

Metabolic Changes in Women Using Levonorgestrel Releasing Intrauterine System

“…Similar data was observed by Vasaraudze et al (11) where they found that the LNG-IUS has no significant adverse effects on any of these parameters, which could further lead to risk of any of the metabolic disorders. In contrast, Bender et al (12) determined an increase in body weight and abdominal circumference.…”

Impact of levonorgestrel intrauterine system on metabolic parameters

“…A longer follow-up with large number of subjects will only lead to know the effect of LNG-IUS on lipid profile. Similar data was observed by Vasaraudze I et al 9 In a randomized comparative study among Asian population, LNG-IUS does not have any adverse effects on lipid metabolism. 10 In present study, in anthropometric data, significant reduction from baseline was seen in case of both BMI and waist circumference at 6 months.…”

“…8 In the present study, SBP was 120.38±5.62mmHg, DBP 74.57±4.59mmHg, and mean fasting blood glucose 86.37±6.61mg/dL. Vasaraudze 9 The occurrence of high BP during use of an LNG-IUS has been studied several times, but none of the studies, with a follow-up of 1-10 years could find a relation. 2 Total cholesterol increased at 6 months; HDL and VLDL increased at 6 and 9 months.…”