Effects of hormonal contraception on systemic metabolism : cross-sectional and longitudinal evidence

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Wang , Q , Wurtz , P , Auro , K , Morin-Papunen , L , Kangas , A J , Soininen , P , Tiainen , M , Tynkkynen , T , Joensuu , A , Havulinna , A S , Aalto , K , Salmi , M , Blankenberg , S , Zeller , T , Viikari , J , Kahonen , M , Lehtimaki , T , Salomaa , V , Jalkanen , S , Jarvelin , M-R , Perola , M , Raitakari , O T , Lawlor , D A , Kettunen , J & Ala-Korpela , M 2016 , ' Effects of hormonal contraception on systemic metabolism : cross-sectional and longitudinal evidence ' , International Journal of Epidemiology , vol. 45 , no. 5 , pp. 1445-1457 . https://doi.org/10.1093/ije/dyw147

Title: Effects of hormonal contraception on systemic metabolism : cross-sectional and longitudinal evidence
Author: Wang, Qin; Wurtz, Peter; Auro, Kirsi; Morin-Papunen, Laure; Kangas, Antti J.; Soininen, Pasi; Tiainen, Mika; Tynkkynen, Tuulia; Joensuu, Anni; Havulinna, Aki S.; Aalto, Kristiina; Salmi, Marko; Blankenberg, Stefan; Zeller, Tanja; Viikari, Jorma; Kahonen, Mika; Lehtimaki, Terho; Salomaa, Veikko; Jalkanen, Sirpa; Jarvelin, Marjo-Riitta; Perola, Markus; Raitakari, Olli T.; Lawlor, Debbie A.; Kettunen, Johannes; Ala-Korpela, Mika
Contributor organization: Institute for Molecular Medicine Finland
University of Helsinki
Department of Obstetrics and Gynecology
Quantitative Genetics
Complex Disease Genetics
Date: 2016-10
Language: eng
Number of pages: 13
Belongs to series: International Journal of Epidemiology
ISSN: 0300-5771
DOI: https://doi.org/10.1093/ije/dyw147
URI: http://hdl.handle.net/10138/176531
Abstract: Background: Hormonal contraception is commonly used worldwide, but its systemic effects across lipoprotein subclasses, fatty acids, circulating metabolites and cytokines remain poorly understood. Methods: A comprehensive molecular profile (75 metabolic measures and 37 cytokines) was measured for up to 5841 women (age range 24-49 years) from three population-based cohorts. Women using combined oral contraceptive pills (COCPs) or progestin-only contraceptives (POCs) were compared with those who did not use hormonal contraception. Metabolomics profiles were reassessed for 869 women after 6 years to uncover the metabolic effects of starting, stopping and persistently using hormonal contraception. Results: The comprehensive molecular profiling allowed multiple new findings on the metabolic associations with the use of COCPs. They were positively associated with lipoprotein subclasses, including all high-density lipoprotein (HDL) subclasses. The associations with fatty acids and amino acids were strong and variable in direction. COCP use was negatively associated with albumin and positively associated with creatinine and inflammatory markers, including glycoprotein acetyls and several growth factors and interleukins. Our findings also confirmed previous results e.g. for increased circulating triglycerides and HDL cholesterol. Starting COCPs caused similar metabolic changes to those observed cross-sectionally: the changes were maintained in consistent users and normalized in those who stopped using. In contrast, POCs were only weakly associated with metabolic and inflammatory markers. Results were consistent across all cohorts and for different COCP preparations and different types of POC delivery. Conclusions: Use of COCPs causes widespread metabolic and inflammatory effects. However, persistent use does not appear to accumulate the effects over time and the metabolic perturbations are reversed upon discontinuation. POCs have little effect on systemic metabolism and inflammation.
Subject: hormonal contraception
combined oral contraceptive pills
progestin-only contraceptives
amino acids
fatty acids
risk factors
30 MU-G
3123 Gynaecology and paediatrics
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion

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