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IMPLANON USE LOWERS PLASMA
CONCENTRATIONS OF
HIGH-MOLECULAR-WEIGHT ADIPONECTIN
Aisya Selvia

Nurmuthmai
nnah

Angga Fachreza

Nur Egis
Vajwin

Cendra Viola
Listi

Suci Martha
Dani

Elvicha Dwi
Vitya R.
Novertha
Mardiah
Pembimbing:
Henny
Savitri
dr. Imelda
E.B Hutagaol, Sp.OG-KFER
KEPANITERAAN KLINIK SENIOR
BAGIAN OBSTETRI DAN GINEKOLOGI
FAKULTAS KEDOKTERAN UNIVERSITAS RIAU
RSUD ARIFIN ACHMAD PROVINSI RIAU
PEKANBARU
2014

ABSTRACT
OBJECTIVE
Investigate the effect of the
low-dosed etonogestrelreleasing contraceptive
implant Implanon on new
cardiovascular risk markers.

Design 
Longitudinal
study.

Setting Familyplanning center of a university hospital. Patient(s) • 40 healthy nonsmokin g women • regular cycles .

sexual hormones. • A second sample  12 weeks after Implanon insertion or in the controls during the early follicular phase of cycle four. HMW. and plasma lipids • A first sampel  in the early follicular phase of the cycle in both groups. .INTERVENT ION • Blood samples  measurements of adiponectin. C-reactive protein (CRP). sex hormone binding globulin.

Main Outcome .

Conclusion .

.

Implanon Insertion .

Adiponectin Has been linked to .

Adiponecti n High .

MATERIAL AND METHODS .

Inclusion .

08 ng/mL .BLOOD SAMPLE enzymelinked immunosor bent assay (ELISA) Coefficients of intraassay variations Sensitivity of the assay is 0.

Statistic al Analysis The unpaired t test and Mann– Whitney Utests Paired T tests or Wilcoxon signed rank test .

RESULT 40 .

07) 06 16 HDL 1.4.18) 4.9 (3.2) 3.4) 6.24 (0. high-sensitivity C-reactive protein.47) 1.08) 3.08 (0.92 (1.55) 2.93) 4.4 (32.6 (35.77 (3.42) 59 06 04 81   .33) 1.25 (1.10 (1. highmolecular weight/adiponectin ratio.18 (1.59) 1.6) 38.4.41 (0.68(0.03) 0.5.7.9.31 (1.60 (0.03) 0.4.28 (0.70) 1.99) 01 01 Kolesterol 5.8) 03 03 0.7) 86 06 4.48 (0.96 (1.11.57 (0.99) 01 64 SHBG 65.3.0 (1.8.7.12) 2.03) 05 12 1.28 (0. adiponectin.97 (2.57 (0.02 (1.5) 52.08 (0.0.1 (3.68 (0.7) HMW 5.4.7) 01 16 Estradiol 116 (49) 112 (60) 184 (181) 262 (287) 01 01 testosteron 1.34 (0.9) 6.02) 2. and sex hormones in controls and before and 3 months after implantation of Implanon.2.45) 1.25 (0. plasma lipids.60 (1.8) 4.26) 1.8 (13.02) 4.25) LDL 3.05 (3.29) 1.0) HA-rasio 0.6.   kontrol (n=15)   Terapi implan (n=17) Variabel baseline 3 mo Adiponektin 7.3 (14.86 (2.03) hsCRP   Baseline Nilai P 3 mo a b 5.Table 1 Levels of high-molecular-weight adiponectin.5.41) 1.68 (0.9) 57.92 (1.8.9 (1.

and blood pressure (37. 115/7 6 mmHg). 20.5 vs. 20. 33.2 vs. body mass index. 120/79 vs.1 years. .RESULT Treatment group N Control N characteristics of age.7 kg/m2 .

or estradiol.After three cycles all parameters in the control group were unchanged implanon treatment did not cause any significant changes in adiponectin. HMW and the HAratio decreased significantly 3 months after insertion of the implant. CRP. .

DISCUSSION This study  investigate the effect of a progestagen-only contraceptive preparation on plasma concentrations of the cardiovascular risk marker total adiponectin and its HMW isomer. The main finding of this prospective nonrandomized controlled study is a significant decrease of HMW in Implanon users 3 months after insertion. .

CRP and HDL are associated with adiponectin levels Based on the finding that baseline testosterone .

they may contribute to the reduction in HMW observed . Although these changes are small.Reduction of HMW adiponectin is associated with the risk of insulin resistance and type 2 diabetes mellitus the area under the curve increases for both parameters. which indicates the induction of an insulin resistance.

In coc user In parameters increase. The concentrations of two favorable cardiovascular risk markers HDL and HMW-adiponectin concentrations decrease. The clinical relevance of these metabolic findings is difficult to interprete because of the combination of favorable (CRP. .The more important clinical question is to understand the consequence of the change in HMW together with the variations in other risk markers with respect to the potential cardiovascular risk of the individual Implanon user. LDL) and unfavorable findings (HMW.

.High-molecular-weight adiponectin is a predictor of progression to metabolic syndrome The difference in HMW levels between cases and controls in studies investigating HMW in relation to other cardiovascular risks is 15% to 25% Implanon is not only used in healthy females.

A major strength of the present study is the prospective controlled design In conclusion. short-term Implanon use in healthy premenopausal women was associated with a decrease in Wadiponectin .

Thank Thank You You Thank You .