Fasting serum lipid, lipoprotein and apolipoprotein profiles were determined in 20 women using a Progestin only - injectable contraceptive (Depo-provera) for long term duration (3 - 6 years). The findings were compared with that of long term users of low dose combined oral contraceptive (Nordette) and appropriately matched controls to evaluate the risk of atherosclerosis after long larm use of steroidal contraceptives using recent cardiovascular disease risk indices.
The mean of serum lipoprotein (a), total cholesterol /HDL- cholesterol and LDL-cholesterol /HDL- cholesterol were significantly higher and the mean of HDL- cholesterol was significantly lower in DMPA users than the controls, while the oral contraceptive group had significantly higher means of total cholesterol, triglycerides, LDL- cholesterol, total cholesterol /HDL- cholesterol, LDL- cholesterol /HDL- cholesterol and lipoprotein (a) and significantly lower HDL- cholesterol and lipoprotein (a) and significantly lower HDL- cholesterol than the controls. Serum lipoprotein (a) level correlated significantly with the body mass index and duration >f use in DMPA group. Also, it correlated significantly with the age and duration of use in the combined oral contraceptive group. The means of serum triglycerides and lipoprotein (a), total cholesterol/ MDL- cholesterol and LDL- cholesterol/ HDL- cholesterol were significantly higher and the mean of HDL- cholesterol was significantly lower in the combined oral contraceptive than the DMPA group. No significant difference was noted in the means of apolipoprotein AI/ apolipoprotein All and apolipoporotein AI/ apoiipoprotein B between the study groups and the controls,
It is concluded that the long term use of steroidal contraceptives is associated with alterations in lipid and apolipoprotein rallies that are unfavourable in terms of risk for atherosclerosis and long term use of low dose combined oral contraceptives may be associated with significantly increased risk than the progestin only-injectable contraceptives.