{"id":440,"date":"2022-12-27T23:36:26","date_gmt":"2022-12-27T22:36:26","guid":{"rendered":"https:\/\/antikoncepcia.org\/?p=440"},"modified":"2022-12-29T10:20:08","modified_gmt":"2022-12-29T09:20:08","slug":"lng-iud-a-srdcovo-cievne-ochorenia","status":"publish","type":"post","link":"https:\/\/antikoncepcia.org\/?p=440","title":{"rendered":"LNG-IUD a srdcovo-cievne ochorenia"},"content":{"rendered":"

Epidemiologick\u00e9 \u00fadaje o riziku srdcovo-cievnych ochoren\u00ed najm\u00e4 u mlad\u00fdch pou\u017e\u00edvateliek LNG-IUD (vn\u00fatromaternicov\u00e9 teliesko uvo\u013e\u0148uj\u00face levonorgestrel\u00a0 (LNG)) s\u00fa nedostato\u010dn\u00e9. Existuj\u00fa v\u0161ak d\u00f4kazy, \u017ee pou\u017e\u00edvanie LNG-IUD m\u00f4\u017ee vies\u0165 k zv\u00fd\u0161eniu krvn\u00e9ho tlaku, k n\u00e1rastu telesnej hmotnosti a k zv\u00fd\u0161eniu hladiny plazmatickej gluk\u00f3zy nala\u010dno, \u010do s\u00fa rizikov\u00e9 faktory srdcovo-cievnych ochoren\u00ed.<\/p>\n

V \u0161t\u00fadii, ktor\u00fa vykonali Heli\u00f6vaara-Peippo a\u00a0kol.<\/em> (2011), po 10 rokoch sledovania mali \u017eeny pou\u017e\u00edvaj\u00face LNG-IUD zv\u00fd\u0161en\u00fa \u00farove\u0148 systolick\u00e9ho (149.7 \u00b1 24.7 mmHg) aj diastolick\u00e9ho tlaku (91.9 \u00b1 12.4 mmHg).[i]<\/a> R\u00f6nnerdag <\/em><\/a>a\u00a0<\/em>Odlind <\/em>(1999)<\/a> zistili, \u017ee dlhodob\u00e9 pou\u017e\u00edvanie LNG-IUD (12 rokov) viedlo u\u00a0mlad\u00fdch \u017eien (22 \u2013 38 rokov) k\u00a0zv\u00fd\u0161eniu systolick\u00e9ho krvn\u00e9ho tlaku o\u00a04 \u2013 10 mmHg, diastolick\u00e9ho krvn\u00e9ho tlaku o\u00a06 \u2013 10 mmHg a\u00a0k\u00a0n\u00e1rastu telesnej hmotnosti s priemern\u00fdm zv\u00fd\u0161en\u00edm o\u00a00.49 kg za rok.[ii]<\/a><\/p>\n

Androg\u00e9nne \u00fa\u010dinky levonorgestrelu sp\u00f4sobuj\u00fa zv\u00fd\u0161enie hmotnosti u pou\u017e\u00edvateliek LNG-IUD. Gemzell-Danielsson a\u00a0kol.<\/em> (2017) zistili priemern\u00e9 kumulat\u00edvne zv\u00fd\u0161enie hmotnosti po 3 rokoch o\u00a01.1 kg. a\u00a0po piatich rokoch o 2.2 kg.[iii]<\/a> V\u00a0 \u0161t\u00fadii, ktor\u00fa vykonali Modesto a\u00a0kol.<\/em> (2015), pou\u017e\u00edvanie LNG-IUD viedlo u\u00a0\u017eien k zv\u00fd\u0161eniu priemernej hmotnosti o\u00a00.7 kg po prvom roku, o\u00a02.7 kg po 4 rokoch a o\u00a04.0 kg po 10 rokoch pou\u017e\u00edvania LNG-IUD.[iv]<\/a> V\u00a0\u0161t\u00fadii, ktor\u00fa vykonali Dal’Ava<\/em><\/a> a\u00a0kol.<\/em> (2012), 12 mesa\u010dn\u00e9 pou\u017e\u00edvanie LNG-IUD s\u00faviselo s v\u00fdznamn\u00fdm n\u00e1rastom telesnej hmotnosti o 2.9 kg (P<\/em>=0.0012) a\u00a0s\u00a0v\u00fdznamn\u00fdm, 2.5% n\u00e1rastom hmotnosti tuku (P<\/em>=0.0009).[v]<\/a><\/p>\n

Kayikcioglu <\/em>a\u00a0kol.<\/em> (2006) pozorovali v\u00fdznamn\u00e9 zv\u00fd\u0161enie priemernej hladiny plazmatickej gluk\u00f3zy nala\u010dno (fasting plasma glucose, FPG) u\u017e po\u010das 1 roka pou\u017e\u00edvania LNG-IUD.[vi]<\/a> Je zn\u00e1me, \u017ee vysok\u00e9 FPG m\u00f4\u017ee zv\u00fd\u0161i\u0165 riziko hemoragickej por\u00e1\u017eky, ischemickej por\u00e1\u017eky, ischemickej choroby srdca, chronickej choroby obli\u010diek a\u00a0tuberkul\u00f3zy.[vii]<\/a><\/p>\n

Bergendal a kol.<\/em> (2014) zistili, \u017ee pou\u017e\u00edvanie LNG-IUD (uvo\u013e\u0148uj\u00face 0.020 \u2013 0.011 mg\/24 h) celkovo nes\u00faviselo so zv\u00fd\u0161en\u00fdm rizikom ven\u00f3zneho tromboembolizmu (OR 0.6), ale riziko bolo v\u00fdznamne zv\u00fd\u0161en\u00e9 u\u00a0pou\u017e\u00edvateliek LNG-IUD, ktor\u00e9 boli nosite\u013eky tzv. Leidenskej mut\u00e1cie (OR 3.2, 95%Cl: 1.2\u201310.4).[viii]<\/a> V\u00e1\u017enym rizikom pou\u017e\u00edvania LNG-IUD je v\u00fdvin intrakrani\u00e1lnej hypertenzie (ICH), pri\u010dom jednou z\u00a0jej komplik\u00e1cii je cievna mozgov\u00e1 pr\u00edhoda.[ix]<\/a> [x]<\/a> Valenzuela a\u00a0kol<\/em>. (2017) hl\u00e1sili takmer 4-n\u00e1sobne zv\u00fd\u0161en\u00e9 riziko intrakrani\u00e1lnej hypertenzie u\u00a0\u017eien pou\u017e\u00edvaj\u00facich LNG-IUD (OR 3.91, 95%CI: 1.89\u20138.06). Rai a\u00a0kol.<\/em> (2015) pozorovali u\u00a0pou\u017e\u00edvateliek LNG-IUD viac ako 7-n\u00e1sobne zv\u00fd\u0161en\u00e9 riziko intrakrani\u00e1lnej hypertenzie (OR 7.7; 95%CI 3.2\u201316.4, P<\/em><0.001).[xi]<\/a> V\u00a0\u0161t\u00fadii, ktor\u00fa vykonali Etminan a\u00a0kol.<\/em> (2015) pou\u017e\u00edvanie LNG-IUD s\u00faviselo s\u00a0takmer 2-n\u00e1sobn\u00fdm zv\u00fd\u0161en\u00edm rizika intrakrani\u00e1lnej hypertenzie (ROR 1.85, 95%Cl: 1.56\u20132.18).[xii]<\/a><\/p>\n

 <\/p>\n

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Odborn\u00e9 pramene<\/strong><\/em><\/p>\n

[i]<\/a> Heli\u00f6vaara-Peippo S, Oksjoki R, Halmesm\u00e4ki K, et al. The effect of hysterectomy or levonorgestrel-releasing intrauterine system on cardiovascular disease risk factors in menorrhagia patients: a 10-year follow-up of a randomised trial. Maturitas. 2011 Aug;69(4):354-8.<\/p>\n

[ii]<\/a> R\u00f6nnerdag M<\/a>, Odlind V<\/a>. Health effects of long-term use of the intrauterine levonorgestrel-releasing system. A follow-up study over 12 years of continuous use. Acta Obstetricia et Gynecologica Scandinavica. 1999 Sep;78(8):716-21.<\/p>\n

[iii]<\/a> Gemzell-Danielsson K, Apter D, Dermout S, et al. Evaluation of a new, low-dose levonorgestrel intrauterine contraceptive system over 5 years of use. European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2017 Mar;210:22-28.<\/p>\n

[iv]<\/a> Modesto W<\/a>, de Nazar\u00e9 Silva dos Santos P<\/a>, Correia VM<\/a>, et al. Weight variation in users of depot-medroxyprogesterone acetate, the levonorgestrel-releasing intrauterine system and a copper intrauterine device for up to ten years of use. The European Journal of Contraception & Reproductive Health Care. 2015 Feb;20(1):57-63.<\/p>\n

[v]<\/a> Dal’Ava N<\/a>, Bahamondes L<\/a>, Bahamondes MV<\/a>, et al. Body weight and composition in users of levonorgestrel-releasing intrauterine system. Contraception.<\/a> 2012 Oct;86(4):350-3.<\/p>\n

[vi]<\/a> Kayikcioglu F<\/a>, Gunes M<\/a>, Ozdegirmenci O<\/a>, Haberal A<\/a>. Effects of levonorgestrel-releasing intrauterine system on glucose and lipid metabolism: a 1-year follow-up study. Contraception.<\/a> 2006 May;73(5):528-31. Epub 2006 Mar 23.<\/p>\n

[vii]<\/a> GBD 2013 Risk Factors Collaborators. Forouzanfar MH, Alexander L, Anderson HR, et al. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990\u20132013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet (London, England). 2015;386(10010):2287-2323.<\/p>\n

[viii]<\/a> Bergendal A<\/a>, Persson I<\/a>, Odeberg J<\/a>. et al. Association of venous thromboembolism with hormonal contraception and thrombophilic genotypes. Obstetrics and Gynecology. 2014 Sep;124(3):600-9.<\/p>\n

[ix]<\/a> Columbia University Department of Neurology. Increased Intracranial Pressure (ICP) Headache. http:\/\/columbianeurology.org\/neurology\/staywell\/document.php?id=42076. Accesed 6 March 2018.<\/p>\n

[x]<\/a> Hardin JS<\/a>, Ramakrishnaiah RH<\/a>, Pemberton JD<\/a>, et al. Idiopathic Intracranial Hypertension Progressing to Venous Sinus Thrombosis, Subarachnoid Hemorrhage, and Stroke. Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society. 2018 Mar;38(1):60-64<\/p>\n

[xi]<\/a> Rai R, Kirk B, Sanders J., et al.\u00a0 The relationship between the levonorgestrel-releasing intrauterine system and idiopathic intracranial hypertension. Investigative Ophthalmology & Visual Science. 2015. 2015; 56(7):2228.<\/p>\n

[xii]<\/a> Etminan M, Luo H, Gustafson P. Risk of intracranial hypertension with intrauterine levonorgestrel. Therapeutic Advances in Drug Safety. 2015;6(3):110-113.<\/p>\n

(zdroj obr\u00e1zka: commons.wikimedia.org)<\/p>\n","protected":false},"excerpt":{"rendered":"

Epidemiologick\u00e9 \u00fadaje o riziku srdcovo-cievnych ochoren\u00ed najm\u00e4 u mlad\u00fdch pou\u017e\u00edvateliek … <\/p>\n","protected":false},"author":4,"featured_media":494,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"footnotes":""},"categories":[164,1,2,57,43],"tags":[336,344,343,188,189,335,341,338,340,339,342,333,187,337,334],"class_list":["post-440","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-porazka","category-psychika","category-rakovina","category-zdravie","category-zmeny-na-sliznici-maternice","tag-androgenne-ucinky","tag-cievna-mozgova-prihoda","tag-intrakranialna-hypertenzia-ich","tag-iud","tag-lng","tag-narast-telesnej-hmotnosti","tag-riziko-chronickej-choroby-obliciek","tag-riziko-hemoragickej-porazky","tag-riziko-ischemickej-choroby-srdca","tag-riziko-ischemickej-porazky","tag-riziko-tuberkulozy","tag-srdcovo-cievne-ochorenia","tag-vnutromaternicove-teliesko","tag-zvysenie-priemernej-hladiny-plazmatickej-glukozy-nalacno","tag-zvyseny-krvny-tlak"],"_links":{"self":[{"href":"https:\/\/antikoncepcia.org\/index.php?rest_route=\/wp\/v2\/posts\/440","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/antikoncepcia.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/antikoncepcia.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/antikoncepcia.org\/index.php?rest_route=\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/antikoncepcia.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=440"}],"version-history":[{"count":3,"href":"https:\/\/antikoncepcia.org\/index.php?rest_route=\/wp\/v2\/posts\/440\/revisions"}],"predecessor-version":[{"id":456,"href":"https:\/\/antikoncepcia.org\/index.php?rest_route=\/wp\/v2\/posts\/440\/revisions\/456"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/antikoncepcia.org\/index.php?rest_route=\/wp\/v2\/media\/494"}],"wp:attachment":[{"href":"https:\/\/antikoncepcia.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=440"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/antikoncepcia.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=440"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/antikoncepcia.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=440"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}