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Oral Contraceptives Tied to Cardiovascular Risk in African American Women

Posted to the Web: Tuesday, July 01 , 2008
NEW YORK (Reuters Health) July 01 - The results of a study published in the June issue of the Journal of Clinical Endocrinology and Metabolism suggest an association between the use of low-dose oral contraceptives and an increase in markers of cardiovascular risk in African American women.

In white women, oral contraceptive use has been found to increase cardiovascular risk by promoting insulin resistance, glucose intolerance, and hypertriglyceridemia, Dr. Anne E. Summer and colleagues from the National Institutes of Health, Bethesda, Maryland, report.

"However, compared with white women, African American women are more insulin resistant, have a higher prevalence of glucose intolerance, and paradoxically lower triglyceride levels," the investigators note. "Therefore, the metabolic effects of oral contraceptive pills observed in white women cannot be extrapolated to African American women."

In a cross-sectional study, the researchers examined the effect of oral contraceptives on insulin resistance, glucose intolerance, and triglycerides in 104 healthy, non-diabetic African American women. Of these subjects, 21 were oral contraceptive pill users and 83 were non-users (controls).

The subjects had a mean age of 34.7 years and a mean BMI of 31. The participants underwent a variety of tests, such as oral glucose tolerance and fasting lipid profiles.

Fasting glucose did not significantly differ between oral contraceptive pill users and non-users.

The women who used oral contraceptives had significantly higher 2-h glucose and fasting triglycerides, and were significantly more insulin resistant than controls.

The results of multiple regression analysis demonstrated that BMI, age, and oral contraceptive pill use were significant determinants of 2-h glucose. These factors were also significantly predictive of high triglyceride levels.

The authors repeated their analyses after categorizing the participants as non-obese (BMI < 30) or obese.

Non-obese oral contraceptive pill users were more insulin resistant than controls. Compared with controls, non-obese oral contraceptive pill users were also more likely to be glucose intolerant.

"Assessing the risks and benefits of oral contraceptive pill use is complex and requires careful consideration in African Americans," the investigators conclude.

J Clin Endocrinol Metab 2008;93:2097-2103.