The effect of combined oral contraceptive and hormonal implant on plasma glucose level and liver function in women: A cross-sectional study

Abstract

 Background: Long-term use of combined oral contraceptives and implant contraceptives was associated
with some adverse metabolic effects, including effects on serum glucose, body weight, and liver
enzymes. However, recent epidemiological reports suggest a possible increased risk of diabetes and liver
disease among users. This study aims to assess the effect of hormonal implants and combined
oral contraceptives use on glucose metabolism and liver function among women who attend family
planning services.

Methods: An institution-based comparative cross-sectional study was conducted to assess the effect of
hormonal implant contraceptives and combined oral contraceptives on glucose metabolism and liver
function status among women of reproductive age from September 15- June 30, 2022. A total of 162
women (86 hormonal implant users, 26 combined oral contraceptive users, and 50 non-users) were
included in the study. A one-way analysis of variance was used to examine differences in outcomes.
Pearson correlation was used to identify the association between outcome variables and the duration of
implant use.

Results: The prevalence of diabetes among study participants in Leku General Hospital and Yirba
Primary Hospital of Sidama Region was 10.5% (95% CI: 6.2- 15.4%). The prevalence of diabetes was
11.6% (95% CI: 5.8-18.6), 11.5% (95% CI: 0-26.9), and 8% (95% CI: 2.0-16.0) among implant users,
combined oral contraceptives users and non-users, respectively. From Bonferroni's post-hoc analysis,
implant users had a significantly higher mean hip-to-waist ratio than non-users (p=0.024). Implant users
had significantly higher mean systolic blood pressure (p = 0.027) than combined oral contraceptive users.
Longer implant use was associated with lower ALT levels (p = 0.044 and r = -0.22).

Conclusion: Longer implant use was associated with lower ALT levels and higher waist-to-hip ratio