کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
3915131 | 1251496 | 2010 | 6 صفحه PDF | دانلود رایگان |
![عکس صفحه اول مقاله: Effects of the levonorgestrel-releasing intrauterine system on cardiovascular risk markers in patients with endometriosis: a comparative study with the GnRH analogue Effects of the levonorgestrel-releasing intrauterine system on cardiovascular risk markers in patients with endometriosis: a comparative study with the GnRH analogue](/preview/png/3915131.png)
BackgroundThe study was conducted to evaluate the cardiovascular risk markers associated with endometriosis and the influence of the levonorgestrel intrauterine system (LNG-IUS) compared with the GnRH analogue (GnRHa) leuprolide acetate on these risk markers after 6 months of treatment.Study DesignThis was a randomized, prospective, open clinical study, with 44 patients with laparoscopically and histologically confirmed endometriosis. Patients were randomized into two groups: the LNG-IUS group, composed of 22 patients who underwent LNG-IUS insertion, and the GnRHa group, composed of 22 patients who received a monthly GnRHa injection for 6 months. Body mass index; systolic and diastolic arterial blood pressure; heart rate; and laboratory cardiovascular risk markers such as interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), C-reactive protein (CRP), homocysteine (HMC), lipid profile, total leukocytes and vascular cell adhesion molecule (VCAM) were measured before and 6 months after treatment.ResultsAfter 6 months of treatment, a significant reduction in pain score occurred in both groups with no significant difference in improvement between the two medications evaluated. In the LNG-IUS group, from pretreatment to posttreatment period, there was a significant reduction in the levels (mean±SD) of VCAM (92.8±4.2 to 91.2±2.7 ng/mL, p=.04), CRP (0.38±0.30 to 0.28±0.21 mg/dL, p=.03), total cholesterol (247.0±85.0 to 180.0±31.0 mg/dL, p=.0002), triglycerides (118.0± 76.0 to 86.5±41.5 mg/dL, p=.003), low-density lipoprotein cholesterol (160.5±66.0 to 114.5±25.5 mg/dL, p=.0005) and high-density lipoprotein cholesterol (63.0±20.5 to 48.5±10.5 mg/dL, p=.002). The GnRHa group showed an increase in HMC levels (11.5±2.9 to 13.0±2.7 μmol/L, p=.04) and a reduction in IL-6 levels (4.3±3.9 to 2.3±0.8 pg/mL, p=.005), VCAM (94.0±3.8 to 92.0±1.6 ng/mL, p=.03) and total leukocytes (7330±2554 to 6350±1778, p=.01). In the GnRH group, the remaining variables, including lipid profile, did not show any statistical difference.ConclusionsThis study shows that some cardiovascular risk markers are influenced by both GnRHa and the LNG-IUS, but the latter had a greater positive impact on the lipid profile, which could lead to a favorable effect during long-term treatment.
Journal: Contraception - Volume 81, Issue 2, February 2010, Pages 117–122