Abstract：
Ovarian cancer incidence has declined in recent decades, due in part to oral contraceptive (OC) use and tubal ligation. However, intrauterine device (IUD) use has increasingly replaced OC use. As ovarian cancer is an inflammation-related disease, we examined the association of OC use, IUD use, and tubal ligation with plasma levels of C-reactive protein (CRP), interleukin 6 (IL-6), and soluble tumor necrosis factor α receptor 2 (sTNFR2), in the Nurses\' Health Study (NHS) and NHSII. After adjusting for reproductive, hormonal, and lifestyle factors, and mutual adjustment for other methods of contraception, there were no differences in inflammatory markers between ever and never use of each method. However, CRP levels decreased from an average 30.4% (-53.6, 4.4) with every 5 years since initial IUD use (P-trend=0.03), while CRP increased an average 9.9% (95% CI: 5.7, 14.3) with every 5 years of use of OC (P-trend<0.0001) as well as differences by BMI and menopausal status. Our results suggest IUD use and tubal ligation are not associated with higher circulating inflammatory markers long term, although long duration of OC use may increase generalized inflammation, which may in part explain why its protective effect wanes over time.
摘要：
近几十年来，卵巢癌发病率有所下降，部分原因是口服避孕药（OC）的使用和输卵管结扎。然而,宫内节育器（IUD）的使用已越来越多地取代OC的使用。因为卵巢癌是一种炎症相关的疾病，我们检查了OC使用的关联，宫内节育器使用,与血浆C反应蛋白（CRP）水平的输卵管结扎，白细胞介素6（IL-6），和可溶性肿瘤坏死因子α受体2（sTNFR2），在护士健康研究(NHS)和NHSII中。在调整生殖后，荷尔蒙，和生活方式因素，和其他避孕方法的相互调整，在使用过和从未使用过的每种方法之间,炎症标志物没有差异.然而,自首次使用宫内节育器以来，CRP水平从平均每5年下降30.4％（-53.6，4.4）（P趋势=0.03），而每5年使用OC，CRP平均增加9.9％（95％CI：5.7，14.3）（P趋势<0.0001），以及BMI和绝经状态的差异。我们的结果表明，宫内节育器使用和输卵管结扎与长期较高的循环炎症标志物无关。虽然长期使用OC可能会增加全身性炎症，这可能在一定程度上解释了为什么它的保护作用会随着时间的推移而减弱。
