Document Detail

Treatment with combined oral contraceptives induces a rise in serum C-reactive protein in the absence of a general inflammatory response.
MedLine Citation:
PMID:  16409455     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The role of inflammation in the pathogenesis of cardiovascular disease is well established. C-reactive protein (CRP) is the strongest independent predictor of myocardial infarction and stroke in women. Recent studies have indicated that CRP levels are raised during use of combined oral contraceptives (COCs). OBJECTIVES: The aim of the study was to investigate the effect of COCs on serum CRP levels and to indicate the underlying mechanisms of an expected increase. METHOD: In a prospective randomized cross over-study 35 women used two different preparations of COC, one second and one third generation. Serum levels of CRP, serum amyloid A (SAA), interleukin-6 (IL-6), tumor necrosis factor alpha (TNFalpha), antibodies against oxidized LDL, insulin and insulin-like growth factor-I (IGF-I) along with insulin-like growth factor binding protein-1 (IGFBP-1) and IGFBP-3 were analyzed before and during the two treatments. E-selectin, von Willebrand factor and factor VIII concentrations in plasma were also measured. RESULTS: A rise in serum CRP was observed during both treatments; the median level increased from 0.45 mg L(-1) at baseline to 1.48 mg L(-1) with second generation and to 2.02 mg L(-1) with third generation COC. The serum levels of SAA increased slightly during treatment with the third generation COC. IL-6 and TNFalpha were unaffected by treatment. Both preparations lowered IGF-I and raised IGFBP-1 and IGFBP-3 concentrations. CONCLUSION: The raised serum CRP concentration during treatment with COCs appears to be related to a direct effect on hepatocyte CRP synthesis and does not reflect IL-6 mediated inflammation, endothelial activation or induction of insulin resistance.
M van Rooijen; L O Hansson; J Frostegård; A Silveira; A Hamsten; K Bremme
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of thrombosis and haemostasis : JTH     Volume:  4     ISSN:  1538-7933     ISO Abbreviation:  J. Thromb. Haemost.     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2006-01-13     Completed Date:  2006-02-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  101170508     Medline TA:  J Thromb Haemost     Country:  England    
Other Details:
Languages:  eng     Pagination:  77-82     Citation Subset:  IM    
Department of Woman and Child Health, Division of Obstetrics and Gynecology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
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MeSH Terms
Biological Markers / blood
C-Reactive Protein / analysis,  biosynthesis*
Contraceptives, Oral, Combined / administration & dosage,  pharmacology*
Cross-Over Studies
Endothelium, Vascular / metabolism
Glucose Metabolism Disorders
Hepatocytes / drug effects,  metabolism
Reg. No./Substance:
0/Biological Markers; 0/Contraceptives, Oral, Combined; 9007-41-4/C-Reactive Protein

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