Sex hormone‐binding globulin as a marker for the thrombotic risk of hormonal contraceptives

@article{Raps2012SexHG,
  title={Sex hormone‐binding globulin as a marker for the thrombotic risk of hormonal contraceptives},
  author={Marjolein Raps and Frans M. Helmerhorst and Kathrin Fleischer and Stella Thomassen and Frits Richard Rosendaal and Jan Rosing and Bart E P B Ballieux and Huib Aam van Vliet},
  journal={Journal of Thrombosis and Haemostasis},
  year={2012},
  volume={10}
}
Summary.  Background: It takes many years to obtain reliable values for the risk of venous thrombosis of hormonal contraceptive users from clinical data. Measurement of activated protein C (APC) resistance via thrombin generation is a validated test for determining the thrombogenicity of hormonal contraceptives. Sex hormone‐binding globulin (SHBG) might serve as a marker for the risk of venous thrombosis, and can be easily and rapidly measured in routine laboratories. 

Sex hormone‐binding globulin as a marker for the thrombotic risk of hormonal contraceptives: a rebuttal

When measured only in women on-treatment SHBG showed a very weak association with normalized activated protein C sensitivity ratios (nAPCsr) determined with the thrombin generation-based APC resistance test, in their opinion SHBG is not a surrogate marker for venous thrombosis.

Sex hormone‐binding globulin levels are not causally related to venous thrombosis risk in women not using hormonal contraceptives

Oral contraceptive use increases the risk of venous thrombosis as well as sex hormone‐binding globulin (SHBG) levels and increased SHBG levels are positively associated with activated protein C (APC) resistance andThrombotic risk in oral contraceptive users.

Sex hormone-binding globulin and thrombin generation in women using hormonal contraception

In hormonal contraceptive users, SHBG was positively associated with both activated protein C (APC) resistance and baseline TG, and protein S and prothrombin were important mediators.

Oral Contraceptives and HRT Risk of Thrombosis

This review attempts to summarize the current knowledge regarding the pathophysiology of oral contraceptive (OC) and hormone replacement therapy (HRT) -induced prothrombotic state in women, the risk of thrombosis associated with administration of various commercially available OCs and HRT, the additional risk in women with hereditary or acquired thromBophilia, and the currently available recommendations.

MECHANISMS IN ENDOCRINOLOGY Epidemiology of hormonal contraceptives-related venous thromboembolism

Current data support that newer generation formulations of hormonal contraceptives as well as non-oral hormonal contraceptives seem to be more thrombogenic than second-generation hormonal contraceptives.

Endogenous sex hormones and risk of venous thromboembolism in young women

The risk of venous thromboembolism (VTE) in young women can predominantly be attributed to exogenous hormone use. The influence of (abnormalities in) endogenous sex hormones, as in polycystic ovary

The effect of different hormonal contraceptives on plasma levels of free protein S and free TFPI.

The effect of oral contraceptives on TFPI and PS is a possible explanation for the increased risk of venous thrombosis associated with oral contraceptives.
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