Oral contraceptive use is associated with a systemic acute phase response

Objective: We determined whether reported intake of oral contraceptives is associated with an acute phase response, since inflammation is important in atherogenesis and may contribute to the thrombo-occlusive complications se en in users of oral contraceptives. Design: Cross-sectional study. Setting: General Community of Augsburg. Subjects: Eight hundred and forty-four women aged 25-44 years, drawn from a random sample of the general population, participating in the MONICA Augsb urg survey 1994/95. Two hundred and thirty women used oral contraceptives a nd 614 did not take any hormones; pregnant women were excluded. Main outcome measures: Plasma C-reactive protein, fibrinogen, and albumin, plasma viscosity and blood cell counts. Results: Age-adjusted plasma levels of C-reactive protein in users of oral contraceptives were almost three times as high as in non-users (2.59 vs. 0. 81 mg/l, P<0.001). Conversely, albumin levels were considerably lower in th ose on oral contraception compared to non-users (40.71 vs. 43.55 g/l, P<0.0 01). Plasma viscosity was marginally higher in users (P=0.05), but fibrinog en and blood cell counts did not differ between the two groups. The results did not change appreciably after adjustment for other relevant risk factor s, including cigarette smoking, body mass index, lipid profile and alcohol consumption, remaining statistically significant at the same level. Conclusion: These results indicate that use of oral contraception is associ ated with a modest, but statistically highly significant, acute phase respo nse, and may be one mechanism by which oral contraceptives increase thrombo embolic risk. (C) 1999 Harcourt Publishers Ltd.