Sadiqa Syed, Masood A Qureshi.
Effects of hormonal Contraception on plasma Lipid and Lipoprotein Cholesterol concentrations.
J Coll Physicians Surg Pak Jan ;12(10):593-8.

Objective: To evaluate the cardiovascular risk factors in Pakistani females, using contraceptives by determining lipid metabolites. Design: The study was carried out prospectively on 70 women aged between 20-45 years and compared with 10 age-matched controls. Place and Duration of Study: The study was conducted at Jinnah Postgraduate Medical Center and KMC Maternity Home, PIB Colony, Karachi and the period of study was 18 months. Patients and Methods: Eighty women with low socio-economic status were selected. They were either uneducated or informally educated and were classified as controls (n=10), oral contraceptive users (OC; n=35) and injectable users (IC; n=35). Contraceptives in practice were: oral tablet Lofemenal and Nordette, and injectables Norigest and implant Norplant. Blood sampling was done in overnight fasting condition and serum total cholesterol (TC), triglycerides (TG), and high-density lipoprotein (HDL-C) were determined by enzymatic colorimetric method, whereas low density (LDL-C), very low-density lipoprotein (VLDL-C) and atherogenic index were calculated by Friedwald`s formula. Results: Lipid metabolite levels in both the groups of contraceptive users showed fluctuations. Borderline and high risk total cholesterol levels were observed in 40% and 13% oral and injectable users respectively, whereas decrease in HDL-C levels was noted in contraceptive users as compared to the controls. Serum TG, LDL-C and VLDL-C did not show significant variations among these groups. Conclusion: Oral and injectable contraceptives of second generation may result in alteration in lipid profiles, though insignificant, when used for long-term (> 3 years). However, short-term use, on the other hand, particularly in the absence of cardiovascular risk factor seems acceptable.


USER COMMENTS

Excellent Article. A must see for every physician working on hormonal Contraception.
Posted by: shariq on Jul 2004

Great article. Dr. Sadiqa's trademark clear and concise descriptions makes understanding harmonal contraception on plasma lipid and lipoprotein cholesterol concentrations. Highly recomended.
Posted by: lamia on Jul 2004

This article is full of technical mistakes indicating that the authors and the so-called research supervisors don't have clear concept of lipid and lipid metabolism. Even the above abstract has mistakes. JCPS, publises such professinally low-standard articles and hence cannot get recognition internationally. Even the the title of the research is technically flaw-bearing."Effects of hormonal contraception on plasma lipid and lipoprotein cholesterol concentrations". Every fraction of lipids (triglyceride, cholesterol, etc) are the components of circulating plasma lipoproteins. Why is there splitting of phrases 'lipoprotein cholesterol' and 'plasma lipid' while all lipids in plasma are contained in various circulating lipoproteins? Friedewald formula (look at the speelings of Friedewald) is considered to calculate the LDL cholesterol concentration but not to calculate VLDL cholesterol (Wilson's formula) and atherogenic index (that is just a ratio of cholesterol contained in two types of lipoproteins viz., LDL and HDL). It is incorrect statement in the said paper that Friedewald formula can calculate VLDL cholesterol and atherogenic index. I have not read the full-text article otherwise I can identify more professional mistakes especially with regards to the statistical anaylyses. HONESTY GROUP
Posted by: honesty on Jul 2004

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