Abstract
Objective: To study the effect of depot-medroxyprogesterone acetate (DMPA) injections on C-reactive protein (CRP) and lipid profile and to find the predictors (body weight, body mass index (BMI), blood pressure (BP) and lipid profile) that significantly predict the risk of cardiovascular disease (CVD) among DMPA injections users.
Method: A prospective cohort study was performed during the period from March 2009 to March 2010 included thirty apparently healthy married women, their age ranged between 20-35 years, who were attending Al-Batool and Al-Khansa Family Planning Centers in Mosul and started (for the first time) to use DMPA injections (150 mg medroxyprogesterone acetate), called "Depo-Provera" as contraceptive. These (DMPA users group) were compared to another 30 healthy married women who did not use any hormonal contraceptives (non users group). Both groups were followed for one year, during which blood samples were obtained from both groups, before starting to use DMPA, after 6 months and after 12 months. Sera were used for the estimation of the biochemical studied parameters using commercial kits except serum low density lipoprotein (LDL) and atherogenic index (AI) which were calculated by special equations.
Results: DMPA injections caused a non significant increase in body weight but a significant increase in BMI after 12 months. There was a significant increase in the mean diastolic blood pressure (DBP) of DMPA users according to the duration of use. The DMPA caused non significant changes in the CRP levels. There was a significant increase in serum triglycerides (TG) after 6 months of DMPA uses with respect to the duration of use. But there were non significant changes in mean serum total cholesterol (TC), high density lipoprotein (HDL), LDL and AI. Among all variables that were studied, only body weight and BMI showed a significant positive correlations with CRP. Using a stepwise multiple regression analysis, it was found that the predictors that significantly predict the risk of CVD among DMPA users were AI, DBP and TG.
Conclusion: This study found that there is a significant positive association between CRP and CVD risk factors in DMPA injections users as contraceptive. Furthermore AI, DBP and TG were found to be significant predictors for the risk of CVD among DMPA users. This study confirmed the safety of DMPA use as contraceptive medication, but that special care should be directed for patients with CVD and other patients who were more sensitive to the harmful effects of lipid in the blood.
Key words: Depot-medroxyprogesterone acetate, CRP, lipid profile.
