Body composition, resting energy expenditure and inflammatory markers: impact in users of depot medroxyprogesterone acetate after 12 months follow-up.

Gisele Almeida Batista,Aglécio Luiz De Souza,Marina Sider,Sarah Monte Alegre,Arlete Maria Fernandes,Vaneska Carvalho Melhado,Daniela Miguel Marin

doi:10.1590/2359-3997000000202

Gisele Almeida Batista, Aglécio Luiz De Souza + Show 5 more

Open Access

https://doi.org/10.1590/2359-3997000000202

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Abstract

The aim of this study was to evaluate for 12 months the changes of body weight using Depot Medroxyprogesterone Acetate (DMPA) and if these changes are related to inflammatory markers. Twenty women of childbearing age who chose the DMPA, without previous use of this method, BMI < 30 kg/m2, and 17 women using IUD TCu 380A, participated in the study. At the baseline and after one year, changes in weight gain, body composition by the bioimpedance electric method, resting energy expenditure (REE) by the indirect calorimetry method, inflammatory markers and HOMA-IR were assessed. After 12 months of evaluation, we could observe a significant increase in the DMPA group in weight (3,01 kg) and BMI, while the IUD group's only significant increase was observed in the BMI. Relative to REE there was an increase of basal metabolic rate (BMR) in both groups after one year. The sub-group DMPA that gained < 3 kg had increased significant weight, BMI and body surface (BS) with respiratory quotient (RQ) reduction, while the sub-group that gained ≥ 3 kg had a significant increase in weight, BMI, BS, fat-free mass, fat mass, BMR, Leptin, HOMA-IR and waist circumference, with RQ significantly reduced. Our study found significant changes in weight, body composition and metabolic profile of the population studied in the first 12 months of contraceptive use. These changes mainly increased body weight, leptin levels and HOMA-IR which can contribute to the development of some chronic complications, including obesity, insulin resistance and diabetes mellitus.

Highlights

Obesity is considered a serious public health problem that affects developed countries as well as developing ones
After 12 months of evaluation, we could observe a significant increase in the Depot medroxyprogesterone acetate (DMPA) group in weight (61.95 kg ± 9.69 x 64.96 kg ± 9.40, p = 0.0007), body mass index (BMI) (23.74 kg/m2 ± 3.47 x 24.88 kg/m2 ± 3.43, p = 0.0007) and body surface (BS) (1.65 ± 0.14 x 1.69 ± 0.13 p = 0.0148), while the IUD group’s only significant increase was observed in the BMI variable (24.26 kg/m2 ± 2.67 x 24.56 kg/m2 ± 2.84, p = 0.0007) (Table 1)
Relative to resting energy expenditure (REE) and respiratory quotient (RQ), there was an increase of basal metabolic rate (BMR) in both groups after one year (DMPA group: 1087.05 kcal/d ± 252.06 x 1319.30 kcal/d ± 133.53, p = 0.0027, IUD group: 1187.59 kcal/d ± 246.23 x 1303.18 kcal/d ± 104.02, p = 0.0027)

Summary

Introduction

Obesity is considered a serious public health problem that affects developed countries as well as developing ones. Most prospective studies that have assessed the body composition of these progestin users, with at least 30 months of use, show a weight gain associated with an increase in body fat deposits [8,9].

Results

Conclusion