{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T21:17:39Z","timestamp":1787865459038,"version":"build-2784847793"},"reference-count":20,"publisher":"The Endocrine Society","issue":"7","license":[{"start":{"date-parts":[[2020,4,18]],"date-time":"2020-04-18T00:00:00Z","timestamp":1587168000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100007798","name":"Research Foundation of the University of Helsinki","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007798","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Hospital District of Helsinki and Uusimaa"},{"DOI":"10.13039\/501100006432","name":"University of Oulu Graduate School","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006432","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Sigrid Juselius Foundation"},{"DOI":"10.13039\/501100002341","name":"Academy of Finland","doi-asserted-by":"publisher","award":["315921"],"award-info":[{"award-number":["315921"]}],"id":[{"id":"10.13039\/501100002341","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002341","name":"Academy of Finland","doi-asserted-by":"publisher","award":["321763"],"award-info":[{"award-number":["321763"]}],"id":[{"id":"10.13039\/501100002341","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Combined oral contraceptives (COCs) alter inflammatory status and lipid metabolism. Whether different estrogens have different effects is poorly understood.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>We compared the effects of COCs containing ethinyl estradiol (EE) or estradiol valerate (EV) and dienogest (DNG) with those containing DNG only on inflammation and lipid metabolism.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Randomized, controlled, open-label clinical trial.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Two-center study in Helsinki and Oulu University Hospitals.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>Fifty-nine healthy, young, nonsmoking women with regular menstrual cycles. Age, body mass index, and waist-to-hip ratio were comparable in all study groups at the beginning. Fifty-six women completed the study (EV + DNG, n = 20; EE + DNG, n = 19; DNG only, n = 17).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Interventions<\/jats:title>\n                  <jats:p>Nine-week continuous use of COCs containing either EV + DNG or EE + DNG, or DNG only as control.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Outcome Measures<\/jats:title>\n                  <jats:p>Parameters of chronic inflammation (high-sensitivity C-reactive protein [hs-CRP], and pentraxin 3 [PTX-3]) and lipid profile (high-density lipoprotein [HDL], low-density lipoprotein [LDL], triglycerides, and total cholesterol).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Serum hs-CRP increased after 9-week use of EE + DNG (mean change \u00b1 standard deviation 1.10 \u00b1 2.11 mg\/L) compared with EV + DNG (\u22120.06 \u00b1 0.97 mg\/L, P = 0.001) or DNG only (0.13 \u00b1 0.68 mg\/L, P = 0.021). Also, PTX-3 increased in the EE + DNG group compared with EV + DNG and DNG-only groups (P = 0.017 and P = 0.003, respectively). In the EE + DNG group, HDL and triglycerides increased compared with other groups (HDL: EE + DNG 0.20 \u00b1 0.24 mmol\/L vs EV + DNG 0.02 \u00b1 0.20 mmol\/L [P = 0.002] vs DNG 0.02 \u00b1 0.18 mmol\/L [P = 0.002]; triglycerides: EE + DNG 0.45 \u00b1 0.21 mmol\/L vs EV + DNG 0.18 \u00b1 0.36 mmol\/L [P = 0.003] vs DNG 0.06 \u00b1 0.18 mmol\/L [P &amp;lt; 0.001]).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>EV + DNG and DNG only had a neutral effect on inflammation and lipids, while EE + DNG increased both hs-CRP and PTX-3 levels as well as triglycerides and HDL.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial Registration<\/jats:title>\n                  <jats:p>ClinicalTrials.gov NCT02352090<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgaa186","type":"journal-article","created":{"date-parts":[[2020,4,18]],"date-time":"2020-04-18T06:45:43Z","timestamp":1587192343000},"page":"e2483-e2490","source":"Crossref","is-referenced-by-count":21,"title":["Estradiol Valerate in COC Has More Favorable Inflammatory Profile Than Synthetic Ethinyl Estradiol: A Randomized Trial"],"prefix":"10.1210","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0514-5981","authenticated-orcid":false,"given":"Marika H","family":"Kangasniemi","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5213-9747","authenticated-orcid":false,"given":"Annina","family":"Haverinen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0736-2891","authenticated-orcid":false,"given":"Kaisu","family":"Luiro","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J Kalervo","family":"Hiltunen","sequence":"additional","affiliation":[{"name":"Faculty of Biochemistry and Molecular Medicine, University of Oulu, Oulu, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6859-3031","authenticated-orcid":false,"given":"Elina K","family":"Komsi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, 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