Biological effects of eleven combined oral contraceptives on serum triglycerides, gamma-glutamyltransferase, alkaline phosphatase, bilirubin and other biochemical variables

The objectives of this paper are to update and quantify the biological effe cts of the most commonly used oral contraceptives (OC) on 15 biochemical te sts currently determined in clinical laboratories and to compare these effe cts between the different types of OC. The sample population was constitute d by 1604 women using combined OCs and the control group comprised 3466 wom en in the same age range not taking medication. Women taking OC were divide d into 11 groups according to the estrogen/progestogen combination. The eff ects of OCs were studied after adjustment for age, weight, height, body mas s index and alcohol and tobacco consumption. The changes observed with the new progestogens were less important than in the past. In comparison with t he controls, the mean serum triglyceride concentration was significantly in creased by +8.5 % to +36.0 % (p<0.05 to p<0.001) in each group while those of total cholesterol and gamma-glutamyltransferase were increased only in 3 and 4 estrogen/progestogen combinations respectively. Conversely, the mean concentrations of alkaline phosphatase, total bilirubin, phosphate and alb umin were significantly decreased. Using a discriminant analysis, three mai n groups according to the type of progestogen were defined: cyproterone ace tate, DL-norgestrel and levonorgestrel, and all other progestogens. The cha nges in serum triglyceride concentration induced by OC intake must be consi dered by the clinician and are useful for taking a clinical and risk decisi on in an individual woman.