Jensen JT, Addis IB, Hennebold JD, Bogan RL. Ovarian Lipid Metabolism Modulates Circulating Lipids in Premenopausal Women.
J Clin Endocrinol Metab 2017;
102:3138-3145. [PMID:
28323981 PMCID:
PMC5587059 DOI:
10.1210/jc.2016-3456]
[Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 01/03/2017] [Indexed: 11/19/2022]
Abstract
CONTEXT
The premenopausal circulating lipid profile may be linked to the hormonal profile and ovarian lipid metabolism.
OBJECTIVE
Assess how estradiol, progesterone, and ovarian lipid metabolism contributes to the premenopausal lipid profile; and evaluate the acute effects of a common hormonal oral contraceptive (OC) on circulating lipids.
DESIGN
Experimental crossover with repeated measures.
SETTING
Academic hospitals.
PATIENTS
Eight healthy, regularly menstruating women.
INTERVENTIONS
Participants underwent periodic serum sampling during a normal menstrual cycle; a standard 21-day, monophasic combined hormonal OC cycle (30 µg of ethinyl estradiol and 150 µg of levonorgestrel per day); menopause simulated by leuprolide acetate (22.5-mg depot); and an artificial menstrual cycle achieved via transdermal estradiol (50 to 300 µg/d) and vaginal micronized progesterone (100 to 300 mg/d).
MAIN OUTCOME MEASURES
Primary outcomes included evaluation of total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein cholesterol, triglycerides, and the total cholesterol to HDL cholesterol ratio. To estimate the effect of estradiol, progesterone, and ovarian lipid metabolism, all specimens except those from the OC cycle were analyzed. Subgroup analysis was conducted on the follicular and luteal phases. In a separate analysis, the effect of the OC was evaluated relative to the normal menstrual cycle.
RESULTS
Estradiol was significantly associated with increased levels of HDL cholesterol throughout the menstrual cycle and in the follicular phase. Ovarian effects were associated with reduced lipid levels, especially during the luteal phase. The OC was associated with an increased total cholesterol to HDL cholesterol ratio and triglycerides.
CONCLUSION
Previously unappreciated factors including ovarian lipid metabolism may contribute to the premenopausal lipid profile.
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