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Previous findings of increased production of large VLDL particles by estrogen have been confirmed in a trial using estrogen-dominant oral contraceptives. Estrogen has been found to have LDL subclass-specific effects and to shift the distribution of apolipoprotein (apo)E from HDL to VLDL. Several recent studies document decreases in lipoprotein (a) Lp(a) levels, but the metabolic mechanism is yet unknown. The effects of progestational agents on lipoprotein metabolism remain unclear in view of conflicting reports.
Sacks et al. (Wed,) studied this question.