Evaluation of lipid profile, high-sensitivity C-reactive protein and D-dimer in users of oral contraceptives of different types

João Victor M Guedes,Natália R Nunes,Melina B Pinheiro,Letícia G R Ferreira,Caroline P Domingueti,Thaís G Vilar

doi:10.5935/1676-2444.20180002

João Victor M Guedes, Natália R Nunes + Show 4 more

Open Access

https://doi.org/10.5935/1676-2444.20180002

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Abstract

ABSTRACT Introduction: The use of oral contraceptives increases women's risk of developing cardiovascular and thromboembolic diseases, due to alterations in hemostatic and lipid profile. Objectives: Analyze the association between the use of different types of oral contraceptives with lipid profile and levels of serum high-sensitivity C-reactive protein (hsCRP) and plasma D-dimer. Methods: One hundred fifty-four participants were divided into the following groups: control nonusers (n = 41), medium-dose users (n= 32), third-generation low-dose users (n = 40), and fourth-generation low-dose users (n = 41). Triglycerides and total cholesterol serum levels were determined by colorimetric enzymatic method; high-density lipoprotein (HDL) cholesterol levels, by precipitation method; low-density lipoprotein (LDL) cholesterol levels, by Friedewald equation; hsCRP levels, by immunoturbidimetric method; and D-dimer levels, by fluorescence immunoassay. Results: Oral contraceptive users had higher serum levels of triglycerides, total cholesterol, HDL cholesterol (HDL-C), HDL/LDL index and hsCRP compared to controls. Medium-dose users had higher D-dimer plasma levels than controls and higher triglycerides serum levels than low-dose users. Triglycerides, hsCRP and D-dimer were positively correlated to each other. Conclusion: The use of combined oral contraceptives was associated with an unfavorable lipid profile and a chronic subclinical inflammation, with atherogenic potential. Furthermore, medium-dose contraceptives induced a higher thrombogenic potential, since they were associated with increased D-dimer levels in comparison to low-dose ones.

Highlights

The use of oral contraceptives increases women’s risk of developing cardiovascular and thromboembolic diseases, due to alterations in hemostatic and lipid profile
The higher risk of cardiovascular events has been associated with changes in lipid metabolism through the modification of low-density lipoprotein (LDL) and high-density lipoprotein cholesterol (HDL-C) levels[3] and the chronic subclinical inflammation[4]
No significant differences were observed between groups with respect to age; body mass index (BMI); systolic and diastolic blood pressure; LDL-C; HDL/total cholesterol (TC) index; family history of thrombosis, breast cancer and cardiovascular disease; physical activity; and time of contraceptive use

Summary

Introduction

The use of oral contraceptives increases women’s risk of developing cardiovascular and thromboembolic diseases, due to alterations in hemostatic and lipid profile. The prolonged use of these contraceptives has advantages that contribute to adherence to treatment, such as reduction of premenstrual tension, relief of menstrual cramps, and improvement in hirsutism and acne[2] They are associated with a higher risk of cardiovascular and thromboembolic diseases in women, such as acute myocardial infarction, ischemic stroke and deep venous thrombosis. The higher risk of cardiovascular events has been associated with changes in lipid metabolism through the modification of low-density lipoprotein (LDL) and high-density lipoprotein cholesterol (HDL-C) levels[3] and the chronic subclinical inflammation[4].

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