Association of HbA1c and total cholesterol levels in child bearing age using injectable contraceptives.

Abstract

Introduction: Injectables contraceptives are convenient and highly effective methods for fertility regulation, being simple to administer and long acting, but affect lipids by increasing total cholesterol and triglycerides¹ , the major health risk of injectables contraceptives are cardiovascular diseases (CVS), particularly heart attacks (myocardial infarction), stroke and venous thromboembolism² Hormonal contraceptives have traditionally being thought to adversely affect carbohydrate metabolism by increasing insulin resistance and decreasing glucose tolerance^.3

Objective: To determine and compare the values of HbA1c and total cholesterol levels in child bearing age using Depot Medroxy Progesterone Acetate (DMPA).

Methodology: This comparative cross-sectional study was conducted at Department of Pharmacology, Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi, from January 2016 to December 2016. Total 200 fertile females in their child bearing age were selected. They were divided into two groups, Group 1 (controls) and Group 2 (DMPA users).  Total cholesterol levels were measured before starting therapy, in the middle and the end of the therapy by using standard procedures on semi- automatic clinical chemistry analyser (Microlab 400). HbA1c levels were measured by using semiautomatic clinical chemistry HbA1c analyser (Microlab 300). Results were analyzed by using Statistical Package for Social Sciences (SPSS) version 21.

Results:  DMPA causes significant increase (p < 0.05) in total cholesterol, but insignificant changes (p > 0.05) in HbA1c levels.

Conclusion: It is suggested that total cholesterol and HbS1c levels should be measured before starting and during the course of injectable contraceptives to the subjects. As deranged cholesterol levels can increase the risk of cardio- vascular disease outcomes^.4 Also injectable contraceptives may cause pre- diabetes (increased in levels of HbA1c 5.7-6.4)⁵.

Key Words:  Depot medroxyprogesterone Acetate (DMPA), Glycated hemoglobin (HbA_1c), Total Cholesterol, Statistical Package for Social Sciences (SPSS).