SHORT-TERM AND LONG-TERM EFFECTS ON LIPID-METABOLISM OF ORAL-CONTRACEPTIVES CONTAINING 30 MU-G ETHINYLESTRADIOL AND 150 MU-G DESOGESTREL OR3-KETO-DESOGESTREL

During a cross-over study with young female volunteers, the effects of a combination of 30 mu g ethinylestradiol (EE) and 150 mu g desogestr el (DG) or 3-ketodesogestrel (KDG) upon lipid metabolism were investig ated on day 3 of the first cycle (day 3/I) and on day 21 of the third cycle of treatment (day 21/III). As compared to the control cycle, tot al cholesterol (CH), low-density lipoprotein CH (LDL-CH), and the apol ipoproteins A-II and B were reduced already on day 3/I, the effects be ing more pronounced with the DG-containing formulation. On day 21/III of treatment with EE/DG, the levels of total CH, LDL-CH and apolipopro tein B did not differ from controls, while apolipoprotein A-II was sig nificantly increased. The effects of EE/KDG were similar, except that on LDL-CH which was still reduced on day 21/III. The serum concentrati ons of total triglycerides (TG), very low-density lipoprotein CH (VLDL -CH), VLDL-TG, LD-TG, high-density lipoprotein CH (HDL-CH), HDL-TG, an d apolipoprotein A-I were not significantly affected on day 3/I, but e levated on day 21/III. As during treatment with EE/KDG the peak level of KDG was higher than with EE/DG, the results indicate a more pronoun ced antagonistic effect of EE/KDG on some EE-induced changes on lipopr oteins during the first days of intake. These short-term changes possi bly reflect a rapid enhancement of hepatic uptake of remnants and LDL by EE. During long-term treatment, the other effects of EE, e.g. the s timulation of hepatic synthesis of TG, VLDL, and HDL and the inhibitio n of hepatic lipoprotein lipase, become apparent.