Liver function in Thai women using different types of hormonal contraceptive agents.

In order to shed light on the relationship of genetic factors with liver disturbance in users of combined oral contraceptives a study was undertaken of 122 Thai women 22 who used no hormonal contraception 25 who used a combination agent (Ovral) 25 who used a low-dose agent (megestrol acetate) and 25 who received injections of depo-provera every 3rd month. Aspartate aminotransferase (SGOT) alanine aminotransferase (SGPT) and lactate dehydrogenase (LDH) activity as well as bromosulphophthalein (BSP) retention (20 mg/kg body weight) were measured. No difference was found among the groups in the mean activities of SGOT and SGPT but the mean activity of LDH was significantly higher in the depo-provera group and BSP retention was significantly higher in the combination group. All groups showed a higher frequency of elevated BSP retention and transaminase activity than has been reported in similar studies in the Western hemisphere suggesting that in Thai women the upper limit of normal should be considered higher than in their Western counterparts. Of course the results of the test could be influenced by nonsymptomatic liver disease. Since these results indicate that more cases of ideopathic jaundice of pregnancy or during combined oral contraceptive use should occur in Thailand than are reported it is possible that the prevalence of other types of jaundice hinders diagnoses of steroid-induced jaundice. Further investigation of the metabolic effects of contraceptive steroids and more data on normal reference values for biochemical tests are needed for tropical populations.