tri-cyclen and Obesity

To evaluate the effects of a commonly used combined hormonal oral contraceptive (OC) on carbohydrate metabolism in obese as compared with lean women.. 6-month prospective study.. Clinical research center at an academic medical center.. Premenopausal nondiabetic women with body mass index <25 kg/m(2) (n = 15) or >30 kg/m(2) (n = 14).. Ethinyl estradiol (35 μg) and norgestimate (0.18/0.215/0.25 mg) for 6 cycles.. Insulin sensitivity by frequent sampling intravenous glucose tolerance test; other indices of insulin sensitivity (homeostatic model assessment of insulin sensitivity index [ISI HOMA], the Matsuda index); fasting lipid panel.. Insulin sensitivity changed from 6.62 ± 3.69 min(-1)/mIU/L (baseline) to 8.23 ± 3.30 min(-1)/mIU/L (6 months) in lean women, and from 4.36 ± 2.32 to 3.82 ± 2.32 min(-1)/mIU/L in obese women. Divergent effects on insulin sensitivity were also observed with ISI HOMA and the Matsuda index. Low-density lipoprotein increased by approximately 20 mg/dL in both the lean and obese groups.. Lean and obese women exhibit differential changes in insulin sensitivity when given 6 months of a commonly used oral contraceptive. The mechanisms of these differences and whether these divergent effects persist in the long term require further investigation.

Topics: Academic Medical Centers; Adult; Analysis of Variance; Blood Glucose; Blood Pressure; Body Mass Index; Contraceptives, Oral, Combined; Contraceptives, Oral, Hormonal; Drug Administration Schedule; Drug Combinations; Ethinyl Estradiol; Female; Glucose Tolerance Test; Humans; Insulin; Insulin Resistance; Lipoproteins, LDL; Norgestrel; Obesity; Prospective Studies; Thinness; Time Factors; Virginia; Young Adult

In this randomized, double-blind, placebo-controlled study, 19 overweight women with polycystic ovary syndrome were randomized to a 3-month course of either metformin plus combined hormonal oral contraceptive (OC) (n = 9) or OC plus matched placebo (n = 10). After 3 months, both treatments had similar effects on androgen levels, lipid profile, insulin sensitivity, and serum inflammatory markers, but flow-mediated dilatation increased by 69.0% in the metformin plus OC group while it remained unchanged in the OC group. CLINICAL TRIAL REGISTRATION NO: NCT00682890.

Topics: Analysis of Variance; Biomarkers; Blood Glucose; Contraceptives, Oral, Combined; Contraceptives, Oral, Hormonal; Double-Blind Method; Drug Combinations; Drug Therapy, Combination; Endothelium, Vascular; Ethinyl Estradiol; Female; Gonadal Steroid Hormones; Humans; Hypoglycemic Agents; Inflammation Mediators; Insulin; Insulin Resistance; Lipids; Metformin; Norgestrel; Obesity; Overweight; Placebo Effect; Polycystic Ovary Syndrome; Time Factors; Treatment Outcome; Vasodilation; Virginia