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Lehmann S, Thomas A, Schiwy-Bochat KH, Geyer H, Thevis M, Glenewinkel F, Rothschild MA, Andresen-Streichert H, Juebner M. Death after misuse of anabolic substances (clenbuterol, stanozolol and metandienone). Forensic Sci Int 2019; 303:109925. [DOI: 10.1016/j.forsciint.2019.109925] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 07/18/2019] [Accepted: 08/02/2019] [Indexed: 02/06/2023]
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Abstract
OBJECTIVE Anabolic-androgenic steroids (AAS) represents a group of synthetic testosterone derivatives that play an important role in clinical treatment. These drugs are widely abused among the general public to increase lean weight and improve athletic performance. It has been reported that AAS use can produce many adverse effects, especially the occurrence of cardiovascular risk. Although there are many related studies, there has been no consensus on AAS use and cardiovascular risk. The present study was to review the effect of AAS on the cardiovascular system. DATA SOURCES The data in this review were obtained from articles included in PubMed and the National Center for Biotechnology Information database. STUDY SELECTION Original articles, case reports, and systematic reviews about AAS were selected for the article. RESULTS The use/abuse of AAS is correlated with higher cardiovascular risks, and many AAS users/abusers had cardiovascular diseases. However, there are many confounding factors in the studies that explored the causality between AAS intake and disease development, and additional studies are required to determine AAS toxicity. CONCLUSION AAS produces toxic effects on the cardiovascular system, and it is necessary to ensure that more people know this about AAS, including medical personnel.
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Affiliation(s)
- Jian-Di Liu
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China
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Marocolo M, Katayama PL, Meireles A, Barbosa Neto O. Combined effects of exercise training and high doses of anabolic steroids on cardiac autonomic modulation and ventricular repolarization properties in rats. Can J Physiol Pharmacol 2019; 97:1185-1192. [PMID: 31505126 DOI: 10.1139/cjpp-2019-0286] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Several studies have reported that high doses of synthetic anabolic androgenic steroids (AAS) can have serious negative effects on health, including the cardiovascular system. The aim of this study was to evaluate the combined effects of AAS and exercise training on ventricular repolarization and cardiac autonomic modulation in rats. Male Wistar rats were allocated into 4 groups: sedentary rats treated with vehicle, sedentary rats treated with nandrolone decanoate, swimming-trained rats treated with vehicle, and swimming-trained rats treated with nandrolone decanoate. Ventricular repolarization was evaluated by electrocardiographic analysis of QT interval and QT dispersion. Cardiac autonomic modulation was assessed by heart rate variability. Our results show that AAS increased QT interval and QT dispersion in sedentary rats treated with nandrolone decanoate as compared to sedentary rats treated with vehicle, indicating AAS-induced ventricular repolarization abnormalities. When rats treated with nandrolone decanoate were subjected to concomitant exercise training, ventricular repolarization was normalized. On the other hand, AAS-induced reduction in cardiac parasympathetic modulation was not prevented by exercise training. In conclusion, AAS produced cardiac autonomic dysfunction and ventricular repolarization disturbances in rats. Combining an exercise training protocol during the AAS treatment attenuated the ventricular repolarization abnormalities and did not prevent cardiac autonomic dysfunction.
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Affiliation(s)
- Moacir Marocolo
- Physiology and Human Performance Research Group, Department of Physiology, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Pedro L Katayama
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University, Araraquara, SP, Brazil
| | - Anderson Meireles
- Physiology and Human Performance Research Group, Department of Physiology, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Octávio Barbosa Neto
- Sport Sciences Department, Federal University of Triangulo Mineiro, Uberaba, MG, Brazil
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Piccirillo G, Moscucci F, Pofi R, D'Alessandro G, Minnetti M, Isidori AM, Francomano D, Lenzi A, Puddu PE, Alexandre J, Magrì D, Aversa A. Changes in left ventricular repolarization after short-term testosterone replacement therapy in hypogonadal males. J Endocrinol Invest 2019; 42:1051-1065. [PMID: 30838540 PMCID: PMC6692303 DOI: 10.1007/s40618-019-01026-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 02/14/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND AIM Evidences suggest that androgen deficiency is associated with sudden cardiac death (SCD). Our purpose was to analyse some electrocardiographic (ECG) markers of repolarization phase in hypogonadal patients either at baseline or after testosterone replacement therapy (TRT). PATIENTS AND METHODS Baseline and after 6 months of testosterone replacement therapy, 14 hypogonadal patients and 10 age-matched controls underwent a short-term ECG recordings at rest and immediately after a maximal exercise test. The following ECG parameters have been collected: QTe (the interval between the q wave the end of T wave), QTp (the interval between the q wave and the peak of T wave), and Te (the interval between the peak and the end of T wave). RESULTS At baseline, in the hypogonadal patients, corrected QTe and QTp values were longer at rest than in the controls at rest (p < 0.05), whereas, during the recovery phase, only the QTp remained significantly longer (p < 0.05). After TRT, hypogonadal patients showed an improvement only in Te (p < 0.05). Conversely, any difference between hypogonadal patients and control subjects was found with respect to the markers of temporal dispersion of repolarization phases, except for a worse QTp → Te coherence (p = 0.001) obtained during the recovery phase. CONCLUSIONS In conclusion, at rest, hypogonadal patients suffer from a stable increase in the myocardial repolarization phase without an increase in its temporal dispersion and, hence, the SCD risk seems to be low.
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Affiliation(s)
- G Piccirillo
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Policlinico Umberto I, "La Sapienza" University of Rome, Viale del Policlinico, 00185, Rome, Italy
| | - F Moscucci
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Policlinico Umberto I, "La Sapienza" University of Rome, Viale del Policlinico, 00185, Rome, Italy.
| | - R Pofi
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - G D'Alessandro
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Policlinico Umberto I, "La Sapienza" University of Rome, Viale del Policlinico, 00185, Rome, Italy
| | - M Minnetti
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - A M Isidori
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - D Francomano
- Division of Internal Medicine and Endocrinology, Madonna delle Grazie Hospital, Velletri, Rome, Italy
| | - A Lenzi
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - P E Puddu
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Policlinico Umberto I, "La Sapienza" University of Rome, Viale del Policlinico, 00185, Rome, Italy
- EA 4650, Signalisation, électrophysiologie et imagerie des lésions d'ischémie reperfusion myocardique, Université de Caen, Normandie, France
| | - J Alexandre
- EA 4650, Signalisation, électrophysiologie et imagerie des lésions d'ischémie reperfusion myocardique, Université de Caen, Normandie, France
- Department of Pharmacology, CHU Caen, Caen, France
| | - D Magrì
- Dipartimento di Medicina Clinica e Molecolare, S. Andrea Hospital, "Sapienza" University of Rome, Rome, Italy
| | - A Aversa
- Department of Experimental and Clinical Medicine, University of Catanzaro « Magna Grecia », Catanzaro, Italy
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55
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Hernández-Guerra AI, Tapia J, Menéndez-Quintanal LM, Lucena JS. Sudden cardiac death in anabolic androgenic steroids abuse: case report and literature review. Forensic Sci Res 2019; 4:267-273. [PMID: 31489392 PMCID: PMC6713204 DOI: 10.1080/20961790.2019.1595350] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 03/11/2019] [Indexed: 12/12/2022] Open
Abstract
Anabolic androgenic steroids (AAS) have several adverse effects on the cardiovascular system that may lead to a sudden cardiac death (SCD). We herein report a case involving a 24-year-old male, AAS abuser with intramuscular delivery in the 6 months before, who suffered a cardiorespiratory arrest at home’s bathtub when returning from New Year’s party. A forensic autopsy was performed according to the guidelines of the Association for European Cardiovascular Pathology (AECVP). The body showed hypertrophy of skeletal musculature, with low amount of subcutaneous fat and no signs of injury (body mass index, BMI: 26.8 kg/m2). On internal examination, there were multiorgan congestion, acute pulmonary edema, and cardiomegaly (420 g) with severe coronary atherosclerosis and superimposed acute occlusive thrombosis at the left main trunk and left anterior descendant. Areas of scarring were located at the intersection between the posterior wall and the posterior third of the septum (postero-septal). At histology, acute myocardial infarction at the anterior third of the septum and the anterior wall, and subacute myocardial infarction at apical septum and apical posterior wall were detected. Other findings were small intramyocardial vessel disease and myocytes hypertrophy. Chemicotoxicological analysis in blood showed ethanol ((0.90 ± 0.05) g/L), stanazolol (11.31 µg/L), nandrolone (2.05 µg/L) and testosterone (<1.00 µg/L). When confronted with a sudden death in a young athlete we must pay attention to the physical phenotype that may suggest AAS abuse and perform a detailed examination of the heart. Chemicotoxicological analysis is a key to establish the relationship between SCD and AAS abuse.
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Affiliation(s)
- Ana Isabel Hernández-Guerra
- Histopathology Service, National Institute of Toxicology and Forensic Sciences (NITFS), Canary Islands Department, Tenerife, Spain
| | - Javier Tapia
- Forensic Pathology Service, Institute of Legal Medicine and Forensic Sciences (ILMFS), Las Palmas de Gran Canaria, Spain
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56
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Cunningham KS, Spears DA, Care M. Evaluation of cardiac hypertrophy in the setting of sudden cardiac death. Forensic Sci Res 2019; 4:223-240. [PMID: 31489388 PMCID: PMC6713129 DOI: 10.1080/20961790.2019.1633761] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 06/17/2019] [Accepted: 06/17/2019] [Indexed: 01/06/2023] Open
Abstract
Ventricular hypertrophy is a common pathological finding at autopsy that can act as a substrate for arrhythmogenesis. Pathologists grapple with the significance of ventricular hypertrophy when assessing the sudden and unexpected deaths of young people and what it could mean for surviving family members. The pathological spectrum of left ventricular hypertrophy (LVH) is reviewed herein. This article is oriented to the practicing autopsy pathologist to help make sense of various patterns of increased heart muscle, particularly those that are not clearly cardiomyopathic, yet present in the setting of sudden cardiac death. The article also reviews factors influencing arrhythmogenesis as well as genetic mutations most commonly associated with ventricular hypertrophy, especially those associated with hypertrophic cardiomyopathy (HCM).
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Affiliation(s)
- Kristopher S Cunningham
- Department of Laboratory Medicine and Pathobiology, Ontario Forensic Pathology Service, University of Toronto, Toronto, Canada
| | - Danna A Spears
- University Health Network, Division of Cardiology - Electrophysiology, University of Toronto, Toronto, Canada
| | - Melanie Care
- Fred A. Litwin Family Centre in Genetic Medicine and Inherited Arrhythmia Clinic, University Health Network & Mount Sinai Hospital, University of Toronto, Toronto, Canada
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Immunodeficiency as a side effect of anabolic androgenic steroid abuse: a case of necrotizing myofasciitis. Forensic Sci Med Pathol 2019; 15:616-621. [PMID: 31359306 DOI: 10.1007/s12024-019-00144-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2019] [Indexed: 12/11/2022]
Abstract
Even if there are well-known consequences of anabolic androgenic steroid (AAS) abuse, their full pathway of action is still being investigated. In this context, the presented case report aims to discuss and provide evidence of unusual adverse effects linked to immunodeficiency in an AAS abuser. In fact, this kind of chronic complication, even if not usually considered, may lead sudden death. In this case a 31-year-old aesthetic weightlifter, who presented to the emergency department due to an accidental fall that resulted in left thigh trauma. This subsequently developed into left thigh necrotizing myofasciitis in the following few days. Although surgery and hyperbaric therapy were carried out, the man died. An autopsy with complete biological sampling for toxicological studies was performed. This case highlights the close relationship between AAS abuse and immunodeficiency and highlights it's importance for further studies. However, it should be considered that of all the dangerous effects produced by AAS use, necrotizing fasciitis is not such an unusual consequence.
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58
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Bertozzi G, Salerno M, Pomara C, Sessa F. Neuropsychiatric and Behavioral Involvement in AAS Abusers. A Literature Review. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E396. [PMID: 31336641 PMCID: PMC6681542 DOI: 10.3390/medicina55070396] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 07/02/2019] [Accepted: 07/18/2019] [Indexed: 12/20/2022]
Abstract
Background and Objectives: Anabolic androgenic steroids (AASs) are a complex group of molecules that include both steroidal androgens and synthetic compounds, derived from testosterone. AASs are commonly used to support pharmacological therapy in cases of primary or secondary hypogonadism, major burns, and neoplastic cachexia. Their prolonged and supra-physiological consumption can provoke several adverse effects on various organs and systems. Among these, the physiopathological mechanisms that induce neuropsychiatric disorders related to AAS abuse are poorly known. For this reason, the proposed review aims to retrace the pathway of action of testosterone to focus on the effects on the central nervous system and specifically highlight the effects of AASs on neuropsychiatric and behavioral functions, as well as on lifestyle. Materials and Methods: This review was conducted using PubMed and Google Scholar databases. On these database websites, we searched for articles from 1 January 1980 to March 2019 using the key terms: "AAS," "Anabolic Androgenic Steroids," "brain," and "neurology." Results: The use of AASs through self-administration yields circulating androgens levels, inducing neuron apoptosis, which is linked to thinner cortex and, in general, less cortical volume. The same alterations affect the putamen. These differences were more evident when correlated with longer use. From a functional point of view, prolonged AAS consumption seemed to be related to lower connectivity between amygdala and frontal, striatal, limbic, hippocampal and visual cortical areas. On the other hand, AAS use seems to negatively condition the positive effects of the sport exercise, reducing its important anti-apoptotic and pro-proliferative functions on the hippocampus, implicated in anxiolytic control. Conclusion: This review clarifies the major aspects of the side effects related to AAS use/abuse highlighting the complex mechanisms on neuropsychiatric and cognitive pathological alterations and also the emotional and behavioral dysfunctions.
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Affiliation(s)
- Giuseppe Bertozzi
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Monica Salerno
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, 95121 Catania, Italy
| | - Cristoforo Pomara
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, 95121 Catania, Italy
| | - Francesco Sessa
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy.
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Weinand J, Kemp WL. Pancreatic Islet Hyperplasia: A Potential Marker for Anabolic-Androgenic Steroid Use. Acad Forensic Pathol 2019; 8:777-785. [PMID: 31240072 DOI: 10.1177/1925362118797755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 07/04/2018] [Indexed: 11/15/2022]
Abstract
It has been estimated that up to four million Americans have used anabolic-androgenic steroids (AAS) to increase muscle mass - either for improved athletic performance, enhanced personal appearance, or both. While the pathologic effects of supra-physiologic doses of AAS have been well-described for some organ systems, such as the cardiovascular system, the effects on other organ systems are less well-described; for example, there is a dearth of knowledge in the medical literature regarding the effects of recreational use of AAS on the islet cells of the endocrine pancreas. As pancreatic islet hyperplasia has previously been described in the literature in a group of patients receiving long-term AAS treatment for Fanconi anemia, it is reasonable to suggest that the use of AAS by bodybuilders could produce the same (or similar) histologic changes. We present a case that offers support for the association of anabolic-androgenic steroid use and pancreatic islet hyperplasia.
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60
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Koundourakis NE, Margioris AN. The complex and bidirectional interaction between sex hormones and exercise performance in team sports with emphasis on soccer. Hormones (Athens) 2019; 18:151-172. [PMID: 31256350 DOI: 10.1007/s42000-019-00115-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 01/07/2019] [Indexed: 10/26/2022]
Abstract
A constant topic reported in the lay press is the effect of sex hormones on athletic performance and their abuse by athletes in their effort to enhance their performance or to either boost or sidestep their hard, protracted, and demanding training regimens. However, an issue that it is almost never mentioned is that the athletic training itself affects the endogenous production of androgens and estrogens, while also being affected by them. Among sports, soccer is a particularly demanding activity, soccer players needing to possess high levels of endurance, strength, and both aerobic and anaerobic capacity, with the very great physiological, metabolic, physical, and psychological exertion required of the players being both influenced by sex steroids and, reciprocally, affecting sex steroid levels. This review focuses on the currently available knowledge regarding the complex relationship between athletic training and competition and sex steroid hormone adaptation to the demands of the exercise effort. In the first part of the review, we will examine the effects of endogenous testosterone, estrogen, and adrenal androgens on athletic performance both during training and in competition. In the second part, we will explore the reciprocal effects of exercise on the endogenous sex hormones while briefly discussing the recent data on anabolic androgenic steroid abuse.
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Affiliation(s)
- Nikolaos E Koundourakis
- Lab of Clinical Chemistry-Biochemistry, Department of Laboratory Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece.
| | - Andrew N Margioris
- Department of Clinical Chemistry, School of Medicine, University of Crete, Heraklion, Crete, Greece
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61
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Abstract
Image- and performance-enhancing drugs include a wide range of substances used to promote physical changes to enhance appearance. Anabolic androgen steroids are the most widely used image- and performance-enhancing drugs along with a wide variety of additional substances. The aim of this study was to identify the pathological changes pertaining to the cardiovascular system possibly involved in the death and characterize the substances associated with steroid use and their possible role in the death. A series of deaths involving image- and performance-enhancing drug users were selected. Nandrolone and testosterone were the most frequently identified steroids. The most commonly illegal drugs found were tetrahydrocannabinol, cocaine, and methadone. Antidepressants, opioids, benzodiazepines, and barbiturates were also found. These findings highlight that results obtained from postmortem investigations should be meticulously evaluated to understand the weight that each identified substance may have played in the death process and exclude any alternative causes of death.
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62
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Helal L, Ferrari F, Stein R. Sudden Death in Young Brazilian Athletes: Isn't It Time We Created a Genuinely National Register? Arq Bras Cardiol 2018; 111:856-859. [PMID: 30517381 PMCID: PMC6263455 DOI: 10.5935/abc.20180207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 06/12/2018] [Indexed: 11/20/2022] Open
Abstract
Young competitive athletes (≤ 35 years old) with or without a previous
diagnosis of cardiovascular disease may suddenly die in competitive activities,
potentially leading to an impact in society through the media. Although the
relative risk for sudden death (SD) in athletes is twice as high as for their
counterparts, the absolute incidence is low. While there is consensus among
medical societies worldwide that early detection of causal factors is highly
desirable, there is debate among different screening schemes to that end. In
Brazil, the recommendations of the Brazilian Society of Cardiology mirror the
guidelines of the European Society of Cardiology (ESC), which indicate a
clinical examination combined with a 12-lead resting electrocardiogram,
regardless of the presence of risk factors. The possibility of genetic screening
is also plausible, since most clinical entities that cause SD in young
competitive athletes are related to genotype. Finally, considering the diversity
of practiced sports, and the population miscegenation, we emphasize the need to
a national registry of cases.
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Affiliation(s)
- Lucas Helal
- Programa de Pós-graduação em Cardiologia e Ciências Cardiovasculares da Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS - Brasil.,Laboratório de Fisiopatologia do Exercício, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS - Brazil
| | - Filipe Ferrari
- Programa de Pós-graduação em Cardiologia e Ciências Cardiovasculares da Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS - Brasil.,Grupo de Pesquisa em Cardiologia do Exercício, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS - Brazil
| | - Ricardo Stein
- Laboratório de Fisiopatologia do Exercício, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS - Brazil.,Grupo de Pesquisa em Cardiologia do Exercício, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS - Brazil.,Departamento de Medicina Interna da Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS - Brazil
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63
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Fitzgerald SJ, Janorkar AV, Barnes A, Maranon RO. A new approach to study the sex differences in adipose tissue. J Biomed Sci 2018; 25:89. [PMID: 30509250 PMCID: PMC6278144 DOI: 10.1186/s12929-018-0488-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 11/15/2018] [Indexed: 11/10/2022] Open
Abstract
Obesity is one of the most invaliding and preventable diseases in the United States. Growing evidence suggests that there are sex differences in obesity in human and experimental animals. However, the specific mechanisms of this disease are unknown. Consequently, there is any particular treatment according to the sex/gender at this time. During the last decade, we observe a rise in the study of adipocyte and the possible mechanisms involved in the different roles of the fat. Furthermore, the effect of sex steroids on the adipocyte is one of the fields that need elucidation. Supporting evidence suggests that sex steroids play an essential role not only in the fat distribution, but also, in its metabolism, proliferation, and function. Thus, using in vitro and in vivo studies will contribute to our fight against this critical health public problem encompassing both sexes. In the present review, we discuss some of the recent advances in the adipocytes and the effect of the sex steroids on the adipose tissue. Also, we propose a new alternative to study the role of sex steroids on adipocyte biology through human adipose-derived stem cells.
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Affiliation(s)
- Sarah Jayne Fitzgerald
- Department of Biomedical Materials Science, School of Dentistry, University of Mississippi Medical Center, Jackson, USA
| | - Amol Vijay Janorkar
- Department of Biomedical Materials Science, School of Dentistry, University of Mississippi Medical Center, Jackson, USA
| | - Allison Barnes
- Department of Cell and Molecular Biology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Rodrigo Oscar Maranon
- Department of Cell and Molecular Biology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA. .,Department of Medicine/Nephrology, School of Medicine, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA. .,Mississippi Center for Excellence in Perinatal Research, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA. .,Cardio Renal Research Center, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA. .,The Women's Health Research Center, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.
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64
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de Souza FR, Sales ARK, Dos Santos MR, Porello RA, Fonseca GWPD, Sayegh ALC, Filho ACB, Pereira RMR, Takayama L, Oliveira TFD, Yonamine M, Negrão CE, Alves MJDNN. Retrograde and oscillatory shear rate in young anabolic androgenic steroid users. Scand J Med Sci Sports 2018; 29:422-429. [PMID: 30387184 DOI: 10.1111/sms.13332] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 10/01/2018] [Accepted: 10/24/2018] [Indexed: 12/16/2022]
Abstract
Disturbed shear rate (SR), characterized by increased retrograde and oscillatory SR in the brachial artery, is associated with inflammation, atherosclerosis, endothelial dysfunction, and sympathetic hyperactivity. Young subjects do not have disturbed SR; however, elderly subjects do, which seems to be associated with sympathetic hyperactivity. Anabolic androgenic steroids (AAS) abuse in young is associated with increased muscle sympathetic nerve activity (MSNA). We hypothesized that AAS users might have disturbed SR. We tested the association between retrograde and oscillatory SR with MSNA. In addition, we measured the high-sensitivity C-reactive protein (hs-CRP). We evaluated 10 male AAS users, age 27 ± 4 years, and 10 age-matched AAS nonusers, age 29 ± 5 years. At rest, retrograde and oscillatory SR were evaluated by Doppler ultrasound, MSNA was measured with microneurography, and hs-CRP was measured in blood sample. Flow-mediated dilation (FMD) was also assessed. AAS users had higher retrograde SR (24.42 ± 17.25 vs 9.15 ± 6.62 s- 1 , P = 0.01), oscillatory SR (0.22 ± 0.13 vs 0.09 ± 0.07 au P = 0.01), and MSNA (42 ± 9 vs 32 ± 4 bursts/100 heart beats, P = 0.018) than nonusers. MSNA (bursts/100 heart beats) was correlated with retrograde SR (r = 0.50, P = 0.050) and oscillatory SR (r = 0.51, P = 0.042). AAS users had higher hs-CRP [1.17 (0.44-3.63) vs 0.29 (0.17-0.70) mg/L, P = 0.015] and decreased FMD (6.42 ± 2.07 vs 8.28% ± 1.53%, P = 0.035) than nonusers. In conclusion, AAS abuse is associated with retrograde and oscillatory SR which were associated with augmented sympathetic outflow. In addition, AAS seems to lead to inflammation characterized by increased hs-CRP. These alterations may have the potential of increasing the early risk of atherosclerotic disease in young AAS users.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Liliam Takayama
- Bone Laboratory Metabolism, Rheumatology, University of São Paulo Medical School, São Paulo, Brazil
| | - Tiago Franco de Oliveira
- Pharmacoscience Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Mauricio Yonamine
- Faculty of Pharmaceutical Sciences, Toxicology, University of São Paulo, São Paulo, Brazil
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Sessa F, Salerno M, Di Mizio G, Bertozzi G, Messina G, Tomaiuolo B, Pisanelli D, Maglietta F, Ricci P, Pomara C. Anabolic Androgenic Steroids: Searching New Molecular Biomarkers. Front Pharmacol 2018; 9:1321. [PMID: 30524281 PMCID: PMC6256094 DOI: 10.3389/fphar.2018.01321] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 10/29/2018] [Indexed: 12/14/2022] Open
Abstract
Even if anabolic androgenic steroid (AAS) abuse is clearly associated with a wide spectrum of collateral effects, adolescents and athletes frequently use a large group of synthetic derivatives of testosterone, both for aesthetic uses and for improving performance. Over the last few years, the development of MicroRNA (miRNA) technologies has become an essential part of research projects and their role as potential molecular biomarkers is being investigated by the scientific community. The circulating miRNAs detection as a diagnostic or prognostic tool for the diagnosis and treatment of several diseases is very useful, because with a minimal quantity of sample (peripheral blood), miRNAs are very sensitive. Even more, miRNAs remain stable both at room temperature and during freeze-thaw cycles. These characteristics highlight the important role of miRNAs in the near future as new tools for anti-doping. The article provides a systematic review and meta-analysis on the role of miRNAs as new potential molecular biomarkers of AAS use/abuse. Particularly, this paper analyzed the “miRNA signature” use as biomarkers for health disorders, focusing on the organ damages which are related to ASS use/abuse. Moreover, this review aims to provide a future prospect for less invasive or non-invasive procedures for the detection of circulating miRNA biomarkers as doping assumption signaling.
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Affiliation(s)
- Francesco Sessa
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Monica Salerno
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giulio Di Mizio
- Department of Legal, Historical, Economic and Social Sciences, University of Catanzaro, Catanzaro, Italy
| | - Giuseppe Bertozzi
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giovanni Messina
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Benedetta Tomaiuolo
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Daniela Pisanelli
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Francesca Maglietta
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Pietrantonio Ricci
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.,Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy
| | - Cristoforo Pomara
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Catania, Italy
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66
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Andrade TU, Haguihara SCGC, Falsoni RMP, Silva CL, Dubois Filho DG, Souza Andrade Moraes F, Nascimento AM, Brasil GA, Lima EM. Stanozolol promotes lipid deposition in the aorta through an imbalance in inflammatory cytokines and oxidative status inLDLrknockoutmice fed a normal diet. Basic Clin Pharmacol Toxicol 2018; 124:360-369. [DOI: 10.1111/bcpt.13143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Accepted: 10/01/2018] [Indexed: 12/31/2022]
Affiliation(s)
- Tadeu Uggere Andrade
- Department of Pharmaceutical Sciences University of Vila Velha Vila Velha Espírito Santo Brazil
| | | | | | - Cristiane Lyrio Silva
- Department of Pharmaceutical Sciences University of Vila Velha Vila Velha Espírito Santo Brazil
| | | | | | | | | | - Ewelyne Miranda Lima
- Department of Pharmaceutical Sciences University of Vila Velha Vila Velha Espírito Santo Brazil
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67
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Garner O, Iardino A, Ramirez A, Yakoby M. Cardiomyopathy induced by anabolic-androgenic steroid abuse. BMJ Case Rep 2018; 2018:bcr-2017-223891. [PMID: 30037963 DOI: 10.1136/bcr-2017-223891] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Bodybuilders use anabolic-androgenic steroids to increase muscle mass, but abuse of these hormones has been related to cardiomyopathy in the past. A 60-year-old Caucasian male bodybuilder with medical history of male hypogonadism and on testosterone replacement therapy, allegedly preparing for a weightlifting competition and receiving stem cell infusions from his trainer, is transferred to the intensive care unit for worsening shortness of breath after failing treatment for community-acquired pneumonia. Chest X-ray on transfer was suggestive of pulmonary oedema, and transthoracic echocardiography showed an ejection fraction of 25%-30%. The patient was taken for cardiac catheterisation, which yielded non-ischaemic cardiomyopathy. His testosterone levels were supratherapeutic. Anabolic-androgenic steroid abuse can be a cause of cardiomyopathy in patients who have no other risk factor for such disease.
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Affiliation(s)
- Orlando Garner
- Internal Medicine, Texas Tech University Health Science Center at the Permian Basin, Odessa, Texas, USA
| | - Alfredo Iardino
- Internal Medicine, Texas Tech University Health Science Center at the Permian Basin, Odessa, Texas, USA
| | - Ana Ramirez
- Internal Medicine, Texas Tech University Health Science Center at the Permian Basin, Odessa, Texas, USA
| | - Maty Yakoby
- Internal Medicine, Texas Tech University Health Science Center at the Permian Basin, Odessa, Texas, USA
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68
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Kahal A, Allem R. Reversible effects of anabolic steroid abuse on cyto-architectures of the heart, kidneys and testis in adult male mice. Biomed Pharmacother 2018; 106:917-922. [PMID: 30119263 DOI: 10.1016/j.biopha.2018.07.038] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 07/07/2018] [Accepted: 07/07/2018] [Indexed: 10/28/2022] Open
Abstract
The importance of the present study comes from the lack of sufficient information about the reversibility of the histopathological alterations which may result from anabolic androgenic drugs abuse after some times of stop treatment, as it is one of the prior studies which explored the negative effects of Deca-Durabolin abuse in particular on the hearts, kidneys and testis structures. For this aim, study was performed on 40 male adult mices. Animals were divided into five groups of 8 animals each as follows: treated by Deca-Durabolin (nandrolone decanoate) at 30 g/kg of BW, weekly during one month (GI); two months (GII); three months (GIII); three months followed by six weeks of treatment discontinuation (GIV) and Control (C). Cytohistological exam was performed to determine histopathological damage in heart, kidney and testis tissues. Results showed that the treated animals supported very well the administrated substance. The increase in muscle strength and the absence of aggression were the most noticeable traits in longer-term treated groups. In addition, the gains in body and heart weights increase with duration of treatment and even more after stopping treatment. Our study showed important degenerative changes and disorganization of the histological structure of heart, kidney and testis in the animals of GIII. These damages worsen again 6 weeks after stopping treatment in heart and kidney, and repairs incompletely in the testis. In conclusion, these results confirmed that the use of AAS is associated with a lot of deleterious effects on the cardiac, nephritic and gonadic tissues which cannot be reversible.
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Affiliation(s)
- Aida Kahal
- Laboratory of Natural Bioresources, Faculty of Science, Department of Biology, University of Hassiba Ben Bouali, BP 151, 02000, Chlef, Algeria.
| | - Rachida Allem
- Laboratory of Natural Bioresources, Faculty of Science, Department of Biology, University of Hassiba Ben Bouali, BP 151, 02000, Chlef, Algeria
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69
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Sretenovic J, Ajdzanovic V, Zivkovic V, Srejovic I, Corbic M, Milosevic V, Jakovljevic V, Milosavljevic Z. Nandrolone decanoate and physical activity affect quadriceps in peripubertal rats. Acta Histochem 2018; 120:429-437. [PMID: 29759662 DOI: 10.1016/j.acthis.2018.04.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 04/27/2018] [Accepted: 04/30/2018] [Indexed: 02/06/2023]
Abstract
Anabolic androgenic steroids (AASs) are synthetic analogs of testosterone often used by athletes to increase the skeletal muscle mass. Our goal was to examine the effects of physical activity and physical activity combined with supraphysiological doses of nandrolone on functional morphology of the quadriceps muscle. The study included 32 peripubertal Wistar rats, divided into 4 groups: control (T-N-), nandrolone (T-N+), physical activity (T+N-) and physical activity plus nandrolone (T+N+) groups. The T+N- and T+N+ group swam for 4 weeks, 1 h/day, 5 days/week. The T-N+ and T+N+ groups received nandolone decanoate (20 mg/kg b.w.) once per week, subcutaneously. Subsequently, the rats were sacrificed and muscle specimens were prepared for the processing. Tissue sections were histochemically and immunohistochemically stained, while the image analysis was used for quantification. Longitudinal diameter of quadriceps muscle cells was increased for 21% in T-N+, for 57% in T+N- and for 64% in T+N+ group while cross section muscle cell area was increased in T-N+ for 19%, in T+N- for 47% and in T+N+ group for 59%, compared to the control. Collagen fibers covered area was increased in T-N+ group for 36%, in T+N- for 109% and in T+N+ group for 159%, compared to the control. Erythrocyte depots were decreased in T-N+ group and increased in T+N- and T+N+ group, in comparison with T-N-. VEGF depots were increased in all treated groups. Chronic administration of supraphysiological doses of AASs alone or in combination with physical activity induces hypertrophy and significant changes in the quadriceps muscle tissue structure.
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Affiliation(s)
- Jasmina Sretenovic
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Vladimir Ajdzanovic
- Department of Cytology, Institute for Biological Research "Sinisa Stankovic", University of Belgrade, Belgrade, Serbia
| | - Vladimir Zivkovic
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Ivan Srejovic
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Milena Corbic
- Clinic of Neurology, KRH Klinikum Agnes Karll Laatzen, Hannover, Germany
| | - Verica Milosevic
- Department of Cytology, Institute for Biological Research "Sinisa Stankovic", University of Belgrade, Belgrade, Serbia.
| | - Vladimir Jakovljevic
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia; Department of Human Pathology, 1st Moscow State Medical University IM Sechenov, Moscow, Russia
| | - Zoran Milosavljevic
- Department of Histology and Embryology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
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70
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Mladěnka P, Applová L, Patočka J, Costa VM, Remiao F, Pourová J, Mladěnka A, Karlíčková J, Jahodář L, Vopršalová M, Varner KJ, Štěrba M. Comprehensive review of cardiovascular toxicity of drugs and related agents. Med Res Rev 2018; 38:1332-1403. [PMID: 29315692 PMCID: PMC6033155 DOI: 10.1002/med.21476] [Citation(s) in RCA: 138] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 10/20/2017] [Accepted: 11/16/2017] [Indexed: 12/12/2022]
Abstract
Cardiovascular diseases are a leading cause of morbidity and mortality in most developed countries of the world. Pharmaceuticals, illicit drugs, and toxins can significantly contribute to the overall cardiovascular burden and thus deserve attention. The present article is a systematic overview of drugs that may induce distinct cardiovascular toxicity. The compounds are classified into agents that have significant effects on the heart, blood vessels, or both. The mechanism(s) of toxic action are discussed and treatment modalities are briefly mentioned in relevant cases. Due to the large number of clinically relevant compounds discussed, this article could be of interest to a broad audience including pharmacologists and toxicologists, pharmacists, physicians, and medicinal chemists. Particular emphasis is given to clinically relevant topics including the cardiovascular toxicity of illicit sympathomimetic drugs (e.g., cocaine, amphetamines, cathinones), drugs that prolong the QT interval, antidysrhythmic drugs, digoxin and other cardioactive steroids, beta-blockers, calcium channel blockers, female hormones, nonsteroidal anti-inflammatory, and anticancer compounds encompassing anthracyclines and novel targeted therapy interfering with the HER2 or the vascular endothelial growth factor pathway.
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Affiliation(s)
- Přemysl Mladěnka
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec KrálovéCharles UniversityHradec KrálovéCzech Republic
| | - Lenka Applová
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec KrálovéCharles UniversityHradec KrálovéCzech Republic
| | - Jiří Patočka
- Department of Radiology and Toxicology, Faculty of Health and Social StudiesUniversity of South BohemiaČeské BudějoviceCzech Republic
- Biomedical Research CentreUniversity HospitalHradec KraloveCzech Republic
| | - Vera Marisa Costa
- UCIBIO, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of PharmacyUniversity of PortoPortoPortugal
| | - Fernando Remiao
- UCIBIO, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of PharmacyUniversity of PortoPortoPortugal
| | - Jana Pourová
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec KrálovéCharles UniversityHradec KrálovéCzech Republic
| | - Aleš Mladěnka
- Oncogynaecologic Center, Department of Gynecology and ObstetricsUniversity HospitalOstravaCzech Republic
| | - Jana Karlíčková
- Department of Pharmaceutical Botany and Ecology, Faculty of Pharmacy in Hradec KrálovéCharles UniversityHradec KrálovéCzech Republic
| | - Luděk Jahodář
- Department of Pharmaceutical Botany and Ecology, Faculty of Pharmacy in Hradec KrálovéCharles UniversityHradec KrálovéCzech Republic
| | - Marie Vopršalová
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec KrálovéCharles UniversityHradec KrálovéCzech Republic
| | - Kurt J. Varner
- Department of PharmacologyLouisiana State University Health Sciences CenterNew OrleansLAUSA
| | - Martin Štěrba
- Department of Pharmacology, Faculty of Medicine in Hradec KrálovéCharles UniversityHradec KrálovéCzech Republic
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71
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Flo FJ, Kanu O, Teleb M, Chen Y, Siddiqui T. Anabolic androgenic steroid-induced acute myocardial infarction with multiorgan failure. Proc (Bayl Univ Med Cent) 2018; 31:334-336. [PMID: 29904303 DOI: 10.1080/08998280.2018.1460130] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 02/28/2018] [Accepted: 03/08/2018] [Indexed: 10/16/2022] Open
Abstract
The abuse of anabolic androgenic steroids (AAS) has remained on the rise despite their well-known deleterious effects. We describe a case of AAS-induced multisystem failure following an extensive history of abuse in a 41-year-old bodybuilder. Furthermore, we review pertinent literature and discuss the different pathophysiologic mechanisms through which AAS affect the heart and other organs. This case points to the possibility of multiorgan involvement and severe cardiac effects of AAS abuse in young individuals who may not have any past medical history.
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Affiliation(s)
- Frederick J Flo
- Department of Emergency Medicine, Texas Tech University Health Science Center Paul L. Foster School of Medicine, El Paso, Texas
| | - Obiajulu Kanu
- Division of Cardiology, Department of Internal Medicine, Texas Tech University Health Science Center Paul L. Foster School of Medicine, El Paso, Texas
| | - Mohamed Teleb
- Division of General Medicine, Department of Internal Medicine, Texas Tech University Health Science Center Paul L. Foster School of Medicine, El Paso, Texas
| | - Yuefeng Chen
- Division of General Medicine, Department of Internal Medicine, Texas Tech University Health Science Center Paul L. Foster School of Medicine, El Paso, Texas
| | - Tariq Siddiqui
- Division of General Medicine, Department of Internal Medicine, Texas Tech University Health Science Center Paul L. Foster School of Medicine, El Paso, Texas
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72
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Salerno M, Cascio O, Bertozzi G, Sessa F, Messina A, Monda V, Cipolloni L, Biondi A, Daniele A, Pomara C. Anabolic androgenic steroids and carcinogenicity focusing on Leydig cell: a literature review. Oncotarget 2018; 9:19415-19426. [PMID: 29721213 PMCID: PMC5922407 DOI: 10.18632/oncotarget.24767] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 02/27/2018] [Indexed: 01/25/2023] Open
Abstract
Anabolic androgenic steroids (AAS) are some of the most common drugs used among athletes, frequently in combination with resistance training, to improve physical performance or for aesthetic purpose. A great number of scientific reports showed the detrimental effects of anabolic androgenic steroids on different organs and tissues. In this literature review, we analyzed the AAS-mediated carcinogenicity, focusing on Leydig cell tumor. AAS-induced carcinogenicity can affect DNA transcription through two pathways. It can act directly via the androgen receptor, by means of dihydrotestosterone (DHT) produced by the action of 5-a-reductase. It can also work through the estrogen receptor, by means of estradiol produced by CYP19 aromatase. In addition, nandrolone and stanazolol can activate the PI3K/AKT and PLC/PKC pathways via IGF-1. This would result in cell proliferation in Leydig cell cancer, or magnify cyclin D1 concentration inducing breast cell proliferation. AAS abuse is becoming a serious public health concern in view of the severe health consequences secondary to AAS abuse. The negative role of AAS in supraphysiological dosage impairs the expression of enzymes involved in testosterone biosynthesis. Abnormal synthesis of testosterone plays has a negative effect on the hormonal changes/regulation, and might be involved in certain carcinogenic mechanisms. At the light of this review, it could become very interesting to perform an information campaign more strengthened in gyms and schools in order to prevent male fertility impairment and other tissues damage.
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Affiliation(s)
- Monica Salerno
- University of Foggia, Department of Clinical and Experimental Medicine, Foggia, Italy
| | - Orazio Cascio
- University of Catania, Department of Medical, Surgical and Advanced Technologies, "G.F. Ingrassia", Catania, Italy
| | - Giuseppe Bertozzi
- University of Foggia, Department of Clinical and Experimental Medicine, Foggia, Italy
| | - Francesco Sessa
- University of Foggia, Department of Clinical and Experimental Medicine, Foggia, Italy
| | - Antonietta Messina
- University of Campania "L. Vanvitelli", Department of Experimental Medicine, Naples, Italy
| | - Vincenzo Monda
- University of Campania "L. Vanvitelli", Department of Experimental Medicine, Naples, Italy
| | - Luigi Cipolloni
- Università degli Studi di Roma "La Sapienza", Department of Public Health, Roma, Italy
| | - Antonio Biondi
- University of Catania, Department of Surgery, Catania, Italy
| | - Aurora Daniele
- University of Campania "L. Vanvitelli", CEINGE Biotecnologie Avanzate S.C. a r.l., Naples, Italy
| | - Cristoforo Pomara
- University of Catania, Department of Medical, Surgical and Advanced Technologies, "G.F. Ingrassia", Catania, Italy
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73
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Althobiti SD, Alqurashi NM, Alotaibi AS, Alharthi TF, Alswat KA. Prevalence, Attitude, Knowledge, and Practice of Anabolic Androgenic Steroid (AAS) Use Among Gym Participants. Mater Sociomed 2018; 30:49-52. [PMID: 29670477 PMCID: PMC5857039 DOI: 10.5455/msm.2018.30.49-52] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: Anabolic steroids (AS) are synthetic testosterone derivatives that last longer than physiological androgens in the body. Anabolic-androgenic steroid (AAS) abuse is spreading among athletes. The aim of this study is to assess the knowledge, attitudes, and practices of gym participants in Saudi Arabia. Methods: A cross-sectional survey was carried out among gym users from February 2017 to May 2017. The questionnaire included information on demographics related to the use of AAS and lifestyle habits. Any willing male gym participant could be included. Results: A total of 4860 male gym participants with a mean age of 28.6 ± 6.2 years were included. A majority were single, with a bachelor’s degree or higher. Moreover, 9.8% of the participants used AAS, of which 76.7% reported improved fitness. Friends were the main source of AAS-related information, but only 38.0% of AAS users sought medical consults. The oral route was most common, and testosterone enanthate was the AAS most used. Conclusion: Also, 9.8% of gym participants used AAS and were more likely to be involved in risky habits, such as smoking and growth hormone abuse. They were less aware of potential complications of AAS, with gym trainers being the predominant source of AAS substances.
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Affiliation(s)
- Sami D Althobiti
- Medical Intern, Taif University School of Medicine, Taif, Saudi Arabia
| | | | | | - Turki F Alharthi
- Medical Intern, Taif University School of Medicine, Taif, Saudi Arabia
| | - Khaled A Alswat
- Internal Medicine, Diabetes, and Endocrinology Certified Clinical Densitometrist. Taif University School of Medicine, Taif, Saudi Arabia
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74
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Vázquez-Mourelle R, Carracedo-Martinez E, Figueiras A. Impact of Health Authority Control Measures Aimed at Reducing the Illicit Use of Anabolic-Androgenic Steroids. Eur Addict Res 2018; 24:28-36. [PMID: 29448243 DOI: 10.1159/000486852] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 01/15/2018] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To evaluate two interventions on anabolic-androgenic-steroids (AAS) dispensation in retail pharmacies. MATERIAL AND METHODS The study was conducted in a north-western region of Spain. Data were the AAS supplied by wholesale drug distributors to retail pharmacies over a period of 102 months. It is designed as an ecological time-series study; the dependent variables were daily defined doses per 1,000 inhabitants per day of each drug. The two interventions evaluated were: (1) an inspection program intended for those retail pharmacies where there was an irregular dispensation and (2) a regulation put forth forcing these pharmacies to carry out additional registers. The medications studied were stanozolol, nandrolone, methenolone, testosterone and mesterolone. RESULTS The pre-intervention use of AAS displayed a rising trend. There was an immediate reduction of 30.56% after the first intervention, and a further reduction of 35.25% after the second. There was a seasonal pattern of use in the pre-intervention period, pointing to an increased demand at the end of spring and beginning of summer. The most abused drugs were stanozolol and nandrolone. CONCLUSION The health actions were very effective, in that they brought about a sharp reduction in the illicit use of AAS. These interventions could be applied to other drugs in which abuse were detected.
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Affiliation(s)
- Raquel Vázquez-Mourelle
- Deputy Manager Galician Health Service (Servicio Gallego de Salud - SERGAS), Galicia Regional Authority, Santiago de Compostela, Spain
| | | | - Adolfo Figueiras
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Santiago de Compostela and Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP) Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
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75
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76
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Dalmasso C, Patil CN, Yanes Cardozo LL, Romero DG, Maranon RO. Cardiovascular and Metabolic Consequences of Testosterone Supplements in Young and Old Male Spontaneously Hypertensive Rats: Implications for Testosterone Supplements in Men. J Am Heart Assoc 2017; 6:JAHA.117.007074. [PMID: 29042425 PMCID: PMC5721890 DOI: 10.1161/jaha.117.007074] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background The safety of testosterone supplements in men remains unclear. In the present study, we tested the hypothesis that in young and old male spontaneously hypertensive rats (SHR), long‐term testosterone supplements increase blood pressure and that the mechanism is mediated in part by activation of the renin‐angiotensin system. Methods and Results In untreated males, serum testosterone exhibited a sustained decrease after 5 months of age, reaching a nadir by 18 to 22 months of age. The reductions in serum testosterone were accompanied by an increase in body weight until very old age (18 months). Testosterone supplements were given for 6 weeks to young (12 weeks‐YMSHR) and old (21–22 months‐OMSHR) male SHR that increased serum testosterone by 2‐fold in young males and by 4‐fold in old males. Testosterone supplements decreased body weight, fat mass, lean mass, and plasma leptin, and increased plasma estradiol in YMSHR but had no effect in OMSHR. Mean arterial pressure (MAP) was significantly higher in OMSHR than in YMSHR and testosterone supplements decreased MAP in OMSHR, but significantly increased MAP in YMSHR. Enalapril, the angiotensin‐converting enzyme inhibitor, reduced MAP in both control and testosterone‐supplemented YMSHR, but had a greater effect on MAP in testosterone‐treated rats, suggesting the mechanism responsible for the increase in MAP in YMSHR is mediated at least in part by activation of the renin‐angiotensin system. Conclusions Taken together with previous studies, these data suggest that testosterone supplements may have differential effects on men depending on age, cardiovascular and metabolic status, and dose and whether given long‐term or short‐term.
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Affiliation(s)
- Carolina Dalmasso
- Department of Biochemistry, University of Mississippi Medical Center, Jackson, MS.,Department of Women's Health Research Center, University of Mississippi Medical Center, Jackson, MS
| | - Chetan N Patil
- Department of Biochemistry, University of Mississippi Medical Center, Jackson, MS.,Department of Women's Health Research Center, University of Mississippi Medical Center, Jackson, MS
| | - Licy L Yanes Cardozo
- Department of Biochemistry, University of Mississippi Medical Center, Jackson, MS.,Department of Medicine, Divisions of Endocrinology/Nephrology, University of Mississippi Medical Center, Jackson, MS.,Department of Women's Health Research Center, University of Mississippi Medical Center, Jackson, MS
| | - Damian G Romero
- Department of Biochemistry, University of Mississippi Medical Center, Jackson, MS.,Department of Women's Health Research Center, University of Mississippi Medical Center, Jackson, MS
| | - Rodrigo O Maranon
- Department of Medicine, Divisions of Endocrinology/Nephrology, University of Mississippi Medical Center, Jackson, MS .,Department of Women's Health Research Center, University of Mississippi Medical Center, Jackson, MS
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77
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Barbosa Neto O, da Mota GR, De Sordi CC, Resende EAMR, Resende LAPR, Vieira da Silva MA, Marocolo M, Côrtes RS, de Oliveira LF, Dias da Silva VJ. Long-term anabolic steroids in male bodybuilders induce cardiovascular structural and autonomic abnormalities. Clin Auton Res 2017; 28:231-244. [DOI: 10.1007/s10286-017-0470-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 09/12/2017] [Indexed: 10/18/2022]
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78
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Lazuras L, Barkoukis V, Loukovitis A, Brand R, Hudson A, Mallia L, Michaelides M, Muzi M, Petróczi A, Zelli A. "I Want It All, and I Want It Now": Lifetime Prevalence and Reasons for Using and Abstaining from Controlled Performance and Appearance Enhancing Substances (PAES) among Young Exercisers and Amateur Athletes in Five European Countries. Front Psychol 2017; 8:717. [PMID: 28588518 PMCID: PMC5438994 DOI: 10.3389/fpsyg.2017.00717] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 04/21/2017] [Indexed: 11/17/2022] Open
Abstract
Doping use in recreational sports is an emerging issue that has received limited attention so far in the psychological literature. The present study assessed the lifetime prevalence of controlled performance and appearance enhancing substances (PAES), and used behavioral reasoning theory to identify the reasons for using and for avoiding using controlled PAES in young exercisers across five European countries, in the context of the “SAFE YOU” Project. Participants were 800 young amateur athletes and exercisers (M = 21.56; SD = 2.69) from Cyprus, Germany, Greece, Italy, and UK who completed an anonymous questionnaire that included measures of self-reported use of controlled PAES, as well as reasons for using and not using controlled PAES. The results of the descriptive analyses demonstrated that almost one out five exercisers in the sample had a previous experience with controlled PAES. Higher prevalence rates were found in Greece and Cyprus and lower in Italy. The most frequently reported reasons for using controlled PAES included achieving the desired results faster; pushing the self to the (physical) limits; and recovering faster after exercise/training. Furthermore, the most frequently reported reasons for not using controlled PAES involved worry about any possible adverse health effects; not feeling the need for using them; and wanting to see what can be achieved naturally without using any controlled PAES. The findings of the present study indicate that the use of controlled PAES is fast becoming a crisis in amateur sports and exercise settings and highlight the need for preventive action and concerted anti-doping education efforts.
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Affiliation(s)
- Lambros Lazuras
- Department of Psychology, Sociology and Politics, Sheffield Hallam UniversitySheffield, UK
| | - Vassilis Barkoukis
- Department of Physical Education and Sport Sciences, Aristotle University of ThessalonikiThessaloniki, Greece
| | - Andreas Loukovitis
- Department of Physical Education and Sport Sciences, Aristotle University of ThessalonikiThessaloniki, Greece
| | - Ralf Brand
- Department of Sport and Exercise Psychology, University of PotsdamPotsdam, Germany
| | - Andy Hudson
- School of Education, Faculty of Health, Social Care and Education, Kingston University and St George's University of LondonLondon, UK
| | - Luca Mallia
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico"Rome, Italy
| | | | - Milena Muzi
- Department of Sport and Exercise Psychology, University of PotsdamPotsdam, Germany
| | - Andrea Petróczi
- School of Life Sciences, Engineering and Computing, Faculty of Science, Engineering and Computing, Kingston UniversityLondon, UK
| | - Arnaldo Zelli
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico"Rome, Italy
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79
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Ventricular androgenic-anabolic steroid-related remodeling: an immunohistochemical study. Int J Legal Med 2017; 131:1589-1595. [DOI: 10.1007/s00414-017-1589-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 04/04/2017] [Indexed: 11/26/2022]
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80
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Pergolizzi B, Carriero V, Abbadessa G, Penna C, Berchialla P, De Francia S, Bracco E, Racca S. Subchronic nandrolone administration reduces cardiac oxidative markers during restraint stress by modulating protein expression patterns. Mol Cell Biochem 2017; 434:51-60. [DOI: 10.1007/s11010-017-3036-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 04/12/2017] [Indexed: 01/20/2023]
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81
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Gentil P, de Lira CAB, Paoli A, Dos Santos JAB, da Silva RDT, Junior JRP, da Silva EP, Magosso RF. Nutrition, Pharmacological and Training Strategies Adopted by Six Bodybuilders: Case Report and Critical Review. Eur J Transl Myol 2017; 27:6247. [PMID: 28458804 PMCID: PMC5391526 DOI: 10.4081/ejtm.2017.6247] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The purpose of this study was to report and analyze the practices adopted by bodybuilders in light of scientific evidence and to propose evidence-based alternatives. Six (four male and two female) bodybuilders and their coaches were directly interviewed. According to the reports, the quantity of anabolic steroids used by the men was 500–750 mg/week during the bulking phase and 720–1160 mg during the cutting phase. The values for women were 400 and 740 mg, respectively. The participants also used ephedrine and hydrochlorothiazide during the cutting phase. Resistance training was designed to train each muscle once per week and all participants performed aerobic exercise in the fasted state in order to reduce body fat. During the bulking phase, bodybuilders ingested ~2.5 g of protein/kg of body weight. During the cutting phase, protein ingestion increased to ~3 g/kg and carbohydrate ingestion decreased by 10–20%. During all phases, fat ingestion corresponded to ~15% of the calories ingested. The supplements used were whey protein, chromium picolinate, omega 3 fatty acids, branched chain amino acids, poly-vitamins, glutamine and caffeine. The men also used creatine in the bulking phase. In general, the participants gained large amounts of fat-free mass during the bulking phase; however, much of that fat-free mass was lost during the cutting phase along with fat mass. Based on our analysis, we recommend an evidence-based approach by people involved in bodybuilding, with the adoption of a more balanced and less artificial diet. One important alert should be given for the combined use of anabolic steroids and stimulants, since both are independently associated with serious cardiovascular events. A special focus should be given to revisiting resistance training and avoiding fasted cardio in order to decrease the reliance on drugs and thus preserve bodybuilders’ health and integrity.
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Affiliation(s)
- Paulo Gentil
- College of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil
| | | | - Antonio Paoli
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | | | | | | | | | - Rodrigo Ferro Magosso
- Post Graduation Program in Movement Sciences, UNESP - Universidade Estadual Paulista, Rio Claro, Brazil
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82
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Povzun SA. [Artificial illness as a result of non-medical use of anabolic androgenic steroids: A case report and a review of literature]. Arkh Patol 2017; 78:48-53. [PMID: 27600782 DOI: 10.17116/patol201678448-53] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
A 42-year-old female body builder who had used anabolic androgenic steroids (AASs) for 18 years to build up muscle mass died from liver rupture. The cause of the latter was multiple abscesses caused by Actinomyces, which developed in the presence of immunodeficiency. The postmortem changes in different organs were due to hormonal imbalance. The paper gives the data available in the literature pertaining to the analysis of the effects of AASs taken in supraphysiological doses on the body and their non-medical application.
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Affiliation(s)
- S A Povzun
- Department of Pathology and Clinical Expertise, I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Care, St.-Petersburg
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83
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Sretenovic J, Zivkovic V, Srejovic I, Milosavljevic Z. The Effects of High Doses of Nandrolone Decanoate on Cardiac Muscle Tissue. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2016. [DOI: 10.1515/sjecr-2016-0021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Abstract
In recent decades, steroid abuse has become very popular and widespread among professional and recreational athletes. The aim of this study was to examine the chronic effects of training combined with high doses of nandrolone decanoate on cardiac muscle tissue. The study included 32 Wistar albino rats divided into 4 groups: control (T-N-), steroid (T-N+), exercisetraining (T+N-) and exercise plus steroid (T+N+) groups. The T+N- and T+N+ group swam for 4 weeks, 1 hour per day, 5 days per week. The N+ (nandrolone positive groups) received nandrolone decanoate (20 mg/kg) once per week, subcutaneously. After 4 weeks of training, the rats were sacrificed. Heart biopsy specimens were routinely fixed and embedded in paraffin. Fivemicrometre thick sections were stained with haematoxylin and eosin (H/E) and Masson-Trichrome dyes. Captured microscopic images were processed by special software for image analysis to quantify results. Our results showed that the combination of nandrolone and training causes left ventricular wall thickening of 30%. Average cardiac muscle cell longitudinal diameter was increased by 6% in the T-N+ group, by 16% in the T+N- group and by 25% in the T+N+ group. The cross sectional muscle cell area was increased in the T+N+ group by 33%. Heart collagen content was increased in the nandrolone group compared to the control group by 261%. Collagen content was decreased in the T+N+ group by 34%. High doses of AAS induced left ventricle hypertrophy and excessive heart collagen deposition.
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Affiliation(s)
- Jasmina Sretenovic
- Department of Physiology, Faculty of Medical Science, University of Kragujevac, Kragujevac, Serbia
| | - Vladimir Zivkovic
- Department of Physiology, Faculty of Medical Science, University of Kragujevac, Kragujevac, Serbia
| | - Ivan Srejovic
- Department of Physiology, Faculty of Medical Science, University of Kragujevac, Kragujevac, Serbia
| | - Zoran Milosavljevic
- Faculty of Medical Sciences Kragujevac, Department of Histology and Embryology Svetozara Markovica 69, 34000 Kragujevac, Serbia
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84
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Hanley Santos G, Coomber R. The risk environment of anabolic-androgenic steroid users in the UK: Examining motivations, practices and accounts of use. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2016; 40:35-43. [PMID: 27955960 DOI: 10.1016/j.drugpo.2016.11.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 10/21/2016] [Accepted: 11/14/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND The numbers using illicit anabolic-androgenic steroids are a cause of concern for those seeking to reduce health harms. Using the 'risk environment' as a conceptual framework to better comprehend how steroid users' practices and perspectives impact on health risks, this paper examines steroid user motivations, patterns of use, and the ways in which these practices are accounted for. METHODS As part of a wider mixed-method study into performance and image enhancing drug (PIED) use and supply in one mid-sized city in South West England, qualitative interviews were undertaken with 22 steroid users. Participants were recruited from a local safer injecting service, rather than bodybuilding gyms, in order to access a wider cross-section of steroid users. A limitation of this approach is potential sample bias towards those showing more health optimising behaviours. RESULTS The research findings highlight that patterns of steroid use varied according to motivation for use, experience and knowledge gained. Most reported having had little or no knowledge on steroids prior to use, with first use being based on information gained from fellow users or suppliers-sometimes inaccurate or incomplete. In accounting for their practices, many users differentiated themselves from other groups of steroid users-for example, older users expressed concern over patterns of use of younger and (what they saw as) inexperienced steroid users. Implicit in these accounts were intimations that the 'other' group engaged in riskier behaviour than they did. CONCLUSION Examining social contexts of use and user beliefs and motivations is vital to understanding how 'risk' behaviours are experienced so that this, in turn, informs harm reduction strategies. This paper examines the ways in which use of steroids is socially situated and the implications of this for policy and practice.
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Affiliation(s)
- Gisella Hanley Santos
- School of Law, Criminology and Government, Plymouth University, Drake Circus, Plymouth PL4 8AA, UK.
| | - Ross Coomber
- Griffith Criminology Institute, Griffith University, Mt Gravatt Campus, Queensland 4122, Australia
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85
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Busardò FP, Bertol E, Mannocchi G, Tittarelli R, Pantano F, Vaiano F, Baglio G, Kyriakou C, Marinelli E. Determination of GHB levels in breast milk and correlation with blood concentrations. Forensic Sci Int 2016; 265:172-81. [DOI: 10.1016/j.forsciint.2016.02.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Revised: 02/09/2016] [Accepted: 02/10/2016] [Indexed: 10/22/2022]
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86
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Nikolic TR, Zivkovic VI, Srejovic IM, Radovanovic DS, Jeremic NS, Jevdjevic MD, Djuric DM, Jakovljevic VL. Acute effects of nandrolone decanoate on cardiodynamic parameters in isolated rat heart. Can J Physiol Pharmacol 2016; 94:1048-1057. [PMID: 27322017 DOI: 10.1139/cjpp-2015-0571] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Despite worldwide use of anabolic steroids in last decades, there is still contradictory information about their acute influence on myocardium. The aim of this study was to examine the acute effects of nandrolone decanoate (ND) on cardiodynamics and coronary flow in isolated rat heart. The hearts of male Wistar albino rats (n = 48, 12 per group, age 8 weeks, body mass 180-200 g) were excised and perfused according to the Langendorff technique at gradually increased coronary perfusion pressures (40-120 cmH2O). After the control sets of experiments, the hearts in different groups were perfused with different doses of ND (1, 10, or 100 μmol/L separately). Using a sensor placed in the left ventricle, we registered maximum and minimum rate of pressure development in the left ventricle (dP/dtmax and dP/dtmin), systolic and diastolic left ventricular pressure (SLVP and DLVP), and heart rate (HR). Coronary flow (CF) was measured flowmetrically. The results clearly show the depression in cardiac function caused by higher doses of ND. The highest concentration of ND (100 μmol/L) induced the most deleterious impact on the myocardial function and perfusion of the heart (coronary circulation), which could be of clinical significance.
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Affiliation(s)
- Tamara R Nikolic
- a Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovica 69, 34000 Kragujevac, Serbia
| | - Vladimir I Zivkovic
- b Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Zmaj Jovina 30, 34000 Kragujevac, Serbia
| | - Ivan M Srejovic
- b Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Zmaj Jovina 30, 34000 Kragujevac, Serbia
| | - Dragan S Radovanovic
- c Department of Physiology, Faculty of Sport and Physical Education, University of Nis, Carnojeviceva 10A, 18000 Nis, Serbia
| | - Nevena S Jeremic
- a Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovica 69, 34000 Kragujevac, Serbia
| | - Maja D Jevdjevic
- d College of Health Studies in Cuprija, Bulevar Vojske bb, 35230 Cuprija, Serbia
| | - Dragan M Djuric
- e Institute of Medical Physiology "Richard Burian", School of Medicine, University of Belgrade, Visegradska 26, 11000 Belgrade, Serbia
| | - Vladimir Lj Jakovljevic
- b Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Zmaj Jovina 30, 34000 Kragujevac, Serbia
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87
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Christou GA, Christou KA, Nikas DN, Goudevenos JA. Acute myocardial infarction in a young bodybuilder taking anabolic androgenic steroids: A case report and critical review of the literature. Eur J Prev Cardiol 2016; 23:1785-1796. [PMID: 27184497 DOI: 10.1177/2047487316651341] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Accepted: 05/04/2016] [Indexed: 11/15/2022]
Abstract
We describe a case report of a 30-year-old bodybuilder suffering acute myocardial infarction (AMI). He had been taking stanozolol and testosterone for two months. The coronary angiogram showed high thrombotic burden in the left anterior descending artery without underlying atherosclerosis. Few case reports of AMI in athletes taking anabolic androgenic steroids (AASs) have been reported so far. AAS-related AMI is possibly underreported in the medical literature due to the desire of the affected individuals to hide AAS use. Physicians should always consider the possibility of AAS abuse in the context of a young athlete suffering AMI. AASs can predispose to AMI through the acceleration of coronary atherosclerosis. Additionally, thrombosis without underlying atherosclerosis or vasospasm is highly possible to cause AMI in AAS users. Complications after AMI may be more frequent in AAS users.
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Affiliation(s)
| | | | - Dimitrios N Nikas
- First Department of Cardiology, University Hospital of Ioannina, Greece
| | - John A Goudevenos
- First Department of Cardiology, University Hospital of Ioannina, Greece
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88
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Alizade E, Avci A, Tabakcı MM, Toprak C, Zehir R, Acar G, Kargin R, Emiroğlu MY, Akçakoyun M, Pala S. Comparison of Right Ventricle Systolic Function between Long-Term Anabolic-Androgenic Steroid User and Nonuser Bodybuilder Athletes: A Study of Two-Dimensional Speckle Tracking Echocardiography. Echocardiography 2016; 33:1178-85. [DOI: 10.1111/echo.13243] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Elnur Alizade
- Cardiology Department; Kartal Kosuyolu Heart Research and Training Hospital; Istanbul Turkey
| | - Anil Avci
- Cardiology Department; Kartal Kosuyolu Heart Research and Training Hospital; Istanbul Turkey
| | - Mehmet Mustafa Tabakcı
- Cardiology Department; Kartal Kosuyolu Heart Research and Training Hospital; Istanbul Turkey
| | - Cuneyt Toprak
- Cardiology Department; Kartal Kosuyolu Heart Research and Training Hospital; Istanbul Turkey
| | - Regayip Zehir
- Cardiology Department; Kartal Kosuyolu Heart Research and Training Hospital; Istanbul Turkey
| | - Goksel Acar
- Cardiology Department; Kartal Kosuyolu Heart Research and Training Hospital; Istanbul Turkey
| | - Ramazan Kargin
- Cardiology Department; Kartal Kosuyolu Heart Research and Training Hospital; Istanbul Turkey
| | - Mehmet Yunas Emiroğlu
- Cardiology Department; Kartal Kosuyolu Heart Research and Training Hospital; Istanbul Turkey
| | - Mustafa Akçakoyun
- Cardiology Department; Kartal Kosuyolu Heart Research and Training Hospital; Istanbul Turkey
| | - Selçuk Pala
- Cardiology Department; Kartal Kosuyolu Heart Research and Training Hospital; Istanbul Turkey
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89
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Turillazzi E, Neri M, Cerretani D, Cantatore S, Frati P, Moltoni L, Busardò FP, Pomara C, Riezzo I, Fineschi V. Lipid peroxidation and apoptotic response in rat brain areas induced by long-term administration of nandrolone: the mutual crosstalk between ROS and NF-kB. J Cell Mol Med 2016; 20:601-12. [PMID: 26828721 PMCID: PMC5125979 DOI: 10.1111/jcmm.12748] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Accepted: 11/02/2015] [Indexed: 02/06/2023] Open
Abstract
The aim of this study was to evaluate the played by oxidative stress in the apoptotic response in different brain areas of rats chronically treated with supra-physiological doses of nandrolone decanoate (ND). Immunohistochemical study and Western blot analysis were performed to evaluate cells' apoptosis and to measure the effects of expression of specific mediators, such as NF-κB (nuclear factor kappa-light-chain-enhancer of activated B cells), Bcl-2 (B-cell lymphoma 2), SMAC/DIABLO (second mitochondria-derived activator of caspases/direct IAP-binding protein with low PI) and VMAT2 (vesicular monoamine transporter 2) on apoptosis. The results of the present study indicate that a long-term administration of ND promotes oxidative injury in rat brain specific areas. A link between oxidative stress and NF-κB signalling pathways is supported by our results. In addition to high levels of oxidative stress, we consistently observed a strong immunopositivity to NF-κB. It has been argued that one of the pathways leading to the activation of NF-κB could be under reactive oxygen species (ROS)-mediated control. In fact, growing evidence suggests that although in limited doses, endogenous ROS may play an activating role in NF-κB signalling, while above a certain threshold, they may negatively impact upon this signalling. However, a mutual crosstalk between ROS and NF-κB exists and recent studies have shown that ROS activity is subject to negative feedback regulation by NF-κB, and that this negative regulation of ROS is the means through which NF-κB counters programmed cells.
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Affiliation(s)
- Emanuela Turillazzi
- Institute of Legal Medicine, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Margherita Neri
- Institute of Legal Medicine, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Daniela Cerretani
- Pharmacology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Italy
| | - Santina Cantatore
- Institute of Legal Medicine, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Paola Frati
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Roma, Italy.,Neuromed, Istituto Mediterraneo Neurologico (IRCCS), Pozzilli, Isernia, Italy
| | - Laura Moltoni
- Pharmacology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Italy
| | - Francesco Paolo Busardò
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Roma, Italy
| | - Cristoforo Pomara
- Institute of Legal Medicine, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Irene Riezzo
- Institute of Legal Medicine, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Vittorio Fineschi
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Roma, Italy
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90
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Thevis M, Kuuranne T, Walpurgis K, Geyer H, Schänzer W. Annual banned-substance review: analytical approaches in human sports drug testing. Drug Test Anal 2016; 8:7-29. [PMID: 26767774 DOI: 10.1002/dta.1928] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 11/10/2015] [Accepted: 11/10/2015] [Indexed: 12/30/2022]
Abstract
The aim of improving anti-doping efforts is predicated on several different pillars, including, amongst others, optimized analytical methods. These commonly result from exploiting most recent developments in analytical instrumentation as well as research data on elite athletes' physiology in general, and pharmacology, metabolism, elimination, and downstream effects of prohibited substances and methods of doping, in particular. The need for frequent and adequate adaptations of sports drug testing procedures has been incessant, largely due to the uninterrupted emergence of new chemical entities but also due to the apparent use of established or even obsolete drugs for reasons other than therapeutic means, such as assumed beneficial effects on endurance, strength, and regeneration capacities. Continuing the series of annual banned-substance reviews, literature concerning human sports drug testing published between October 2014 and September 2015 is summarized and reviewed in reference to the content of the 2015 Prohibited List as issued by the World Anti-Doping Agency (WADA), with particular emphasis on analytical approaches and their contribution to enhanced doping controls.
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Affiliation(s)
- Mario Thevis
- Center for Preventive Doping Research, Institute of Biochemistry, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany.,European Monitoring Center for Emerging Doping Agents, Cologne/Bonn, Germany
| | - Tiia Kuuranne
- Doping Control Laboratory, United Medix Laboratories, Höyläämötie 14, 00380, Helsinki, Finland
| | - Katja Walpurgis
- Center for Preventive Doping Research, Institute of Biochemistry, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
| | - Hans Geyer
- Center for Preventive Doping Research, Institute of Biochemistry, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
| | - Wilhelm Schänzer
- Center for Preventive Doping Research, Institute of Biochemistry, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
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91
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Choi SM, Lee BM. Comparative safety evaluation of selective androgen receptor modulators and anabolic androgenic steroids. Expert Opin Drug Saf 2015; 14:1773-85. [DOI: 10.1517/14740338.2015.1094052] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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92
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Lusetti M, Licata M, Silingardi E, Reggiani Bonetti L, Palmiere C. Pathological changes in anabolic androgenic steroid users. J Forensic Leg Med 2015; 33:101-4. [PMID: 26048507 DOI: 10.1016/j.jflm.2015.04.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 04/08/2015] [Accepted: 04/24/2015] [Indexed: 11/29/2022]
Abstract
Several classes of recreational and prescription drugs have additional effects on the heart and vasculature, which may significantly contribute to morbidity and mortality in chronic users. The study presented herein focuses on pathological changes involving the heart possibly due to anabolic androgenic steroid use. The role these hormones may play in their occurrence of sudden cardiac death is also investigated. 98 medico-legal cases including 6 anabolic androgenic steroid users were retrospectively reviewed. Autopsies, histology, immunohistochemistry, biochemistry and toxicology were performed in all cases. Pathological changes consisted of various degrees of interstitial and perivascular fibrosis as well as fibroadipous metaplasia and perineural fibrosis within the myocardium of the left ventricle. Within the limits of the small number of investigated cases, our results appear to confirm former observations on this topic and suggest anabolic androgenic steroid's potential causative role in the pathogenesis of sudden cardiac deaths in chronic users.
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Affiliation(s)
- Monia Lusetti
- Department of Diagnostic Medicine, Clinical and Public Health, University of Modena and Reggio Emilia, Section of Legal Medicine, Modena, Italy
| | - Manuela Licata
- Department of Diagnostic Medicine, Clinical and Public Health, University of Modena and Reggio Emilia, Section of Legal Medicine, Modena, Italy
| | - Enrico Silingardi
- Department of Diagnostic Medicine, Clinical and Public Health, University of Modena and Reggio Emilia, Section of Legal Medicine, Modena, Italy
| | - Luca Reggiani Bonetti
- Department of Diagnostic Medicine, Clinical and Public Health, University of Modena and Reggio Emilia, Section of Clinical Pathology, Modena, Italy
| | - Cristian Palmiere
- University Center of Legal Medicine, Lausanne University Hospital, Lausanne, Switzerland.
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93
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Coomber R, Pavlidis A, Santos GH, Wilde M, Schmidt W, Redshaw C. The supply of steroids and other performance and image enhancing drugs (PIEDs) in one English city: Fakes, counterfeits, supplier trust, common beliefs and access. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.peh.2015.10.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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