ESPEYB21 12. Type 2 Diabetes, Metabolic Syndrome and Lipids Lipid Metabolism (5 abstracts)
12.13. Influence of oral contraceptives on lipid profile and trajectories in healthy adolescents-data from the EVA-tyrol study
Staudt A , Kiechl SJ , Gande N , Hochmayr C , Bernar B , Stock K , Geiger R , Egger A , Griesmacher A , Knoflach M , Kiechl-Kohlendorfer U & Early Vascular Ageing (EVA) Study Group.
J Adolesc Health. 2024;75(3):479-486. doi:10.1016/j.jadohealth.2024.04.017.
Brief Summary: In a large cohort of healthy adolescents, oral contraceptive (OC) users showed an higher LDL and triglyceride blood levels than non-users. Similarly, lipid trajectories over time showed an increase in LDL and triglyceride levels.
Comment: Oral contraceptives (OCs) are widely used among young women. Studies in adults reported that OCs increase triglyceride levels, but effects on LDL levels were inconsistent. However, many of these studies were based on older OC formulations. The current study assessed the impact of OC use on lipid levels, BMI and blood pressure in youth.
Firstly, the authors performed a cross-sectional analysis of data from 317 adolescents OC users (mostly using monophasic combined OC) compared with 511 OC non-users. OC use was robustly associated with total and LDL-cholesterol as well as triglyceride levels, in models adjusted for age, socioeconomic status, BMI z-score, physical activity, and diet. Triglycerides levels were ~48.6% higher in OC users. Increases in BMI and blood pressure were statistically significant, but the differences were mild and of doubtful clinical relevance.
Secondly, they performed a longitudinal analysis of 558 female adolescents, with an average 22 months duration of follow-up. Mean LDL increased by 15 mg/dL, and triglycerides by 36 mg/dL. Changes in BMI did not differ between those who initiated, continued, or discontinued OCs.
These changes are especially relevant for adolescents with other risk factors for dyslipidemia, such as severe obesity, T2D or other cardiovascular risk factors (1). When morbid obesity, severe hypertension, micro- or macrovascular disease, or multiple cardiovascular risk factors are present, it is advisable to prioritize use of progestin-only or nonhormonal contraceptive methods.
Reference: 1. Merino PM, Codner E. Contraception for Adolescents and Young Women with Type 2 Diabetes-Specific Considerations. Curr Diab Rep. 2022 Feb;22(2):77-84.
Volume 21
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ESPE Yearbook of Paediatric Endocrinology
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