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Cardiometabolic Risk Marker Changes in Centrally Obese Women Using Depot Medroxyprogesterone Acetate (DMPA) in
Evelyne Kantarama1, Dieudonne Uwizeye2, Annette Uwineza3
1Department of Medical Biochemistry, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
Background:
Hormonal contraceptives, such as depot medroxyprogesterone acetate (DMPA), are known to increase the risk of cardiometabolic disease, especially in obese users who are already at high risk.
Objectives:
This study aimed to evaluate changes in lipid profile, glycated hemoglobin (HbA1C), blood pressure (BP), and inflammatory markers over a 12-month follow-up in centrally obese women using DMPA in Rwanda.
Methods:
A prospective study involving 65 abdominally obese women (aged 15-49 years) was conducted at two family planning centres in Kigali. Measurements were taken at baseline, six months, and twelve months, including a lipid profile, HbA1c, BP, and high-sensitivity C-reactive protein (hs-CRP). Changes were analyzed using the Wilcoxon signed-rank test, with a significance level of 5%.
Results:
The study demonstrated significant changes in the median of cardiometabolic parameters over 12 months of DMPA use. WC increased from 96(41) to 99.5(44) cm, TG from 1.15(2.40) to 1.53(3.63) mmol/L, while HDL-c decreased from 1.09(1.55) to 0.90(0.99) mmol/L (all P=0.001). Lipid ratios also increased significantly, where the TC/HDL-c increased from 3.54(5.92) to 5.99(8.58), and LDL-c/HDL-c from 2.63(4.8) to 4.68(7.38) (P=0.001).
Conclusion:
Given these findings, assessing central obesity before initiating DMPA and performing cardiovascular risk evaluations every six months is recommended to mitigate adverse effects.
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