1
|
Buhl LF, Lehmann Christensen L, Diederichsen A, Lindholt JS, Kistorp CM, Glintborg D, Andersen M, Frystyk J. Impact of androgenic anabolic steroid use on cardiovascular and mental health in Danish recreational athletes: protocol for a nationwide cross-sectional cohort study as a part of the Fitness Doping in Denmark (FIDO-DK) study. BMJ Open 2024; 14:e078558. [PMID: 38719280 PMCID: PMC11086435 DOI: 10.1136/bmjopen-2023-078558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 04/26/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION The use of androgenic anabolic steroids (AASs) among recreational athletes is steadily increasing. However, knowledge regarding the potentially harmful effects of AAS primarily originates from case reports and small observational studies. This large-scale study aims to investigate the impact of AAS use on vascular plaque formation, preclinical coronary disease, cardiac function, circulating cardiovascular risk markers, quality of life (QoL) and mental health in a broad population of illicit AAS users. METHODS AND ANALYSES A nationwide cross-sectional cohort study including a diverse population of men and women aged ≥18 years, with current or previous illicit AAS use for at least 3 months. Conducted at Odense University Hospital, Denmark, the study comprises two parts. In part A (the pilot study), 120 recreational athletes with an AAS history will be compared with a sex-matched and age-matched control population of 60 recreational athletes with no previous AAS use. Cardiovascular outcomes include examination of non-calcified coronary plaque volume and calcium score using coronary CT angiography, myocardial structure and function via echocardiography, and assessing carotid and femoral artery plaques using ultrasonography. Retinal microvascular status is evaluated through fundus photography. Cardiovascular risk markers are measured in blood. Mental health outcomes include health-related QoL, interpersonal difficulties, body image concerns, aggression dimensions, anxiety symptoms, depressive severity and cognitive function assessed through validated questionnaires. The findings of our comprehensive study will be used to compose a less intensive investigatory cohort study of cardiovascular and mental health (part B) involving a larger group of recreational athletes with a history of illicit AAS use. ETHICS AND DISSEMINATION The study received approval from the Regional Committee on Health Research Ethics for Southern Denmark (S-20210078) and the Danish Data Protection Agency (21/28259). All participants will provide signed informed consent. Research outcomes will be disseminated through peer-reviewed journals and scientific conferences. TRIAL REGISTRATION NUMBER NCT05178537.
Collapse
Affiliation(s)
- Laust Frisenberg Buhl
- Department of Endocrinology, University of Southern Denmark Faculty of Health Sciences, Odense, Denmark
| | | | - Axel Diederichsen
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | | | - Caroline Michaela Kistorp
- Department of Hormones and Metabolism, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Kobenhavn, Denmark
| | - Dorte Glintborg
- Department of Endocrinology, Faculty of Health Sciences University of Southern Denmark, Odense, Denmark
| | - Marianne Andersen
- Department of Endocrinology, Faculty of Health Sciences University of Southern Denmark, Odense, Denmark
| | - Jan Frystyk
- Department of Endocrinology, Faculty of Health Sciences University of Southern Denmark, Odense, Denmark
| |
Collapse
|
2
|
Gregersen I, Scarth ME, Abdullah R, Thorsby PM, Hauger LE, Haugaa KH, Sagen EL, Michelsen AE, Ueland T, Edvardsen T, Aukrust P, Almaas VM, Bjørnebekk AK, Halvorsen B. Elevated interleukin 8 and matrix metalloproteinase 9 levels are associated with myocardial pathology in users of Anabolic-Androgenic Steroids. Eur J Prev Cardiol 2024:zwae126. [PMID: 38573232 DOI: 10.1093/eurjpc/zwae126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 03/21/2024] [Accepted: 03/25/2024] [Indexed: 04/05/2024]
Abstract
AIM In the current paper, we aim to explore the effect of both current and former long-term anabolic-androgenic steroid (AAS) use on regulation of systemic inflammatory markers and mediators of extracellular matrix (ECM) remodeling and their association with hormones and echocardiographic myocardial pathology in weightlifters. METHODS In a cross-sectional study, 93 weightlifting AAS-users, of which 62 were current and 31 were past users, with at least one-year cumulative AAS-use (mean 11±7 accumulated years of AAS-use), were compared to 54 non-using weightlifting controls (WLC) using clinical interview, blood pressure measurements, and echocardiography. RESULTS Serum levels of interleukin (IL)-6, IL-8, tumor necrosis factor (TNF), interferon (IFN)γ, growth differentiation factor (GDF)-15 and matrix metalloproteinase (MMP-9), sex hormones and lipids were analyzed. Serum levels of IL-8, GDF-15 and MMP-9 were significantly increased in current AAS users compared to former users and WLC. MMP-9, but not IL-8, correlated consistently with sex-hormone levels, and sex-hormone levels correlated consistently with mean wall thickness, in current users. Moreover, HDL cholesterol was significantly lower in current versus former AAS users, in significantly inversely correlated with MMP-9 in current users. Further, in current users, MMP-9 and IL-8 correlated with markers of myocardial strain, and MMP9 also with indices of cardiac mass, which was not seen in former users. Mediation analyses suggested that MMP-9 could partly explain hormone-induced alterations in markers of myocardial damage in current users. CONCLUSION In conclusion, long-term AAS is associated with increased levels of markers of inflammation and extracellular matrix remodeling, which seems to have a hormone-dependent (MMP-9) and hormone-independent (IL-8) association with markers of myocardial dysfunction.
Collapse
Affiliation(s)
- Ida Gregersen
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
| | - Morgan Elizabeth Scarth
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Rang Abdullah
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- ProCardio Center for Research Based Innovation, Department of Cardiology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Per Medbøe Thorsby
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Hormone Laboratory, Department of Medical Biochemistry and Biochemical Endocrinology and Metabolism Research Group, Oslo University Hospital, Aker, Oslo, Norway
| | - Lisa E Hauger
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- National Centre for Epilepsy, Section for Clinical Psychology and Neuropsychology, Oslo University Hospital
| | - Kristina H Haugaa
- ProCardio Center for Research Based Innovation, Department of Cardiology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ellen Lund Sagen
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Annika E Michelsen
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Thor Ueland
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Thrombosis Research Center (TREC), Division of internal medicine, University hospital of North Norway, Tromsø Norway
| | - Thor Edvardsen
- ProCardio Center for Research Based Innovation, Department of Cardiology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Pål Aukrust
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Vibeke Marie Almaas
- ProCardio Center for Research Based Innovation, Department of Cardiology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
| | - Astrid Kristine Bjørnebekk
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Bente Halvorsen
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
3
|
Antza C, Gallo A, Boutari C, Ershova A, Gurses KM, Lewek J, Mirmaksudov M, Silbernagel G, Sandstedt J, Lebedeva A. Prevention of cardiovascular disease in young adults: Focus on gender differences. A collaborative review from the EAS Young Fellows. Atherosclerosis 2023; 384:117272. [PMID: 37734996 DOI: 10.1016/j.atherosclerosis.2023.117272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 05/03/2023] [Accepted: 09/01/2023] [Indexed: 09/23/2023]
Abstract
A steady rise in cardiovascular morbidity and mortality has been observed in young adults within the last decades. This trend corresponds to an increasing prevalence of traditional cardiovascular risk factors such as obesity and diabetes mellitus type 2 among young adults living in developed countries. Moreover, age-specific risk factors, such as substance abuse, contraceptive medication, and pregnancy-related diseases also correlate with an increased incidence of cardiovascular diseases. In this review, we discuss the available data for young adults on the epidemiology and the rationale for the causality of traditional and newly emerging risk factors of atherosclerotic cardiovascular diseases. We focus on gender-related differences in the exposure to these risk factors, investigate the recent data regarding screening and risk stratification in the young adult population, and describe the current state of the art on lifestyle and therapeutic intervention strategies in the primary prevention setting.
Collapse
Affiliation(s)
- Christina Antza
- 3rd Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Papageorgiou Hospital, 56429, Thessaloniki, Greece
| | - Antonio Gallo
- Sorbonne Université, INSERM UMR1166, Lipidology and Cardiovascular Prevention Unit, Department of Nutrition, APHP, Pitié-Salpètriêre Hospital, F-75013, Paris, France
| | - Chrysoula Boutari
- 2nd Propaedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642, Thessaloniki, Greece
| | - Alexandra Ershova
- Laboratory of Clinomics, National Medical Research Centre for Therapy and Preventive Medicine, Petroverigskiy Pereulok, 10, 101990, Moscow, Russia
| | - Kadri Murat Gurses
- Department of Cardiology, Selçuk University, School of Medicine, 42250, Selçuklu, Konya, Turkey
| | - Joanna Lewek
- Department of Preventive Cardiology and Lipidology, Chair of Nephrology and Hypertension, Medical University of Lodz, Rzgowska St. 281/289, 93-338, Lodz, Poland; Department of Cardiology and Adult Congenital Heart Diseases, Polish Mother's Memorial Hospital Research Institute (PMMHRI), Rzgowska St. 281/289, 93-338, Lodz, Poland
| | - Mirakhmadjon Mirmaksudov
- Department of Electrophysiology, Republican Specialized Scientific Practical Medical Centre of Cardiology, Osiyo St. 4, 100052, Tashkent, Uzbekistan
| | - Günther Silbernagel
- Division of Vascular Medicine, Department of Internal Medicine, Medical University of Graz, Auenbruggerpl. 2, 8036, Graz, Austria
| | - Joakim Sandstedt
- Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, 41390, Gothenburg, Sweden; Department of Clinical Chemistry, Sahlgrenska University Hospital, 41390, Gothenburg, Sweden
| | - Anna Lebedeva
- Clinic of Internal Medicine and Cardiology, Heart Centre Dresden University Hospital, Dresden University of Technology, Fetscherst. 76, 01307, Dresden, Germany.
| |
Collapse
|
4
|
Souza FRD, Rochitte CE, Silva DC, Sampaio B, Passarelli M, Santos MRD, Fonseca GW, Battaglia Filho AC, Correa K, do Val RM, Yonamine M, Pereira RMR, Negrão CE, Kalil-Filho R, Alves MJDNN. Coronary Inflammation by Computed Tomography Pericoronary Fat Attenuation and Increased Cytokines in Young Male Anabolic Androgenic Steroid Users. Arq Bras Cardiol 2023; 120:e20220822. [PMID: 37991119 PMCID: PMC10697680 DOI: 10.36660/abc.20220822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 08/09/2023] [Accepted: 08/16/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Anabolic androgenic steroid (AAS) abuse has been associated with coronary artery disease (CAD). Pericoronary fat attenuation (pFA) is a marker of coronary inflammation, which is key in the atherosclerotic process. OBJECTIVE To evaluate pFA and inflammatory profile in AAS users. METHODS Twenty strength-trained AAS users (AASU), 20 AAS nonusers (AASNU), and 10 sedentary controls (SC) were evaluated. Coronary inflammation was evaluated by mean pericoronary fat attenuation (mPFA) in the right coronary artery (RCA), left anterior descending coronary artery (LAD), and left circumflex (LCx). Interleukin (IL)-1 (IL-1), IL-6, IL-10, and TNF-alpha were evaluated by optical density (OD) in a spectrophotometer with a 450 nm filter. P<0.05 indicated statistical significance. RESULTS AASU had higher mPFA in the RCA (-65.87 [70.51-60.70] vs. -78.07 [83.66-72.87] vs.-78.46 [85.41-71.99] Hounsfield Units (HU), respectively, p<0.001) and mPFA in the LAD (-71.47 [76.40-66.61] vs. -79.32 [84.37-74.59] vs. -82.52 [88.44-75.81] HU, respectively, p=0.006) compared with AASNU and SC. mPFA in the LCx was not different between AASU, AASNU, and SC (-72.41 [77.17-70.37] vs. -80.13 [86.22-72.23] vs. -78.29 [80.63-72.29] HU, respectively, p=0.163). AASU compared with AASNU and SC, had higher IL-1, (0.975 [0.847-1.250] vs. 0.437 [0.311-0.565] vs. 0.530 [0.402-0.780] OD, respectively, p=0.002), IL-6 (1.195 [0.947-1.405] vs. 0.427 [0.377-0.577] vs. 0.605 [0.332-0.950] OD, p=0.005) and IL-10 (1.145 [0.920-1.292] vs. 0.477 [0.382-0.591] vs. 0.340 [0.316-0.560] OD, p<0.001). TNF-α was not different between the AASU, AASNU, and SC groups (0.520 [0.250-0.610] vs. 0.377 [0.261-0.548] vs. 0.350 [0.182-430]), respectively. CONCLUSION Compared with ASSNU and controls, AASU have higher mPFA and higher systemic inflammatory cytokines profile suggesting that AAS may induce coronary atherosclerosis through coronary and systemic inflammation.
Collapse
Affiliation(s)
- Francis Ribeiro de Souza
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Carlos E Rochitte
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Douglas Carli Silva
- Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo , SP - Brasil
| | - Barbara Sampaio
- Instituto de Medicina Tropical de São Paulo , São Paulo , SP - Brasil
| | - Marisa Passarelli
- Universidade de São Paulo - Faculdade de Medicina - Laboratório de Lípides , São Paulo , SP - Brasil
- Universidade Nove de Julho , São Paulo , SP - Brasil
| | - Marcelo R Dos Santos
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
- Hospital Israelita Albert Einstein , São Paulo , SP - Brasil
| | - Guilherme W Fonseca
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Antonio Carlos Battaglia Filho
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Kelly Correa
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Renata Margarida do Val
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Maurício Yonamine
- Universidade de São Paulo - Faculdade de Ciências Farmacêuticas , São Paulo , SP - Brasil
| | - Rosa Maria R Pereira
- Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo , SP - Brasil
| | - Carlos Eduardo Negrão
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Roberto Kalil-Filho
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
- Hospital Sírio Libanês , São Paulo , SP - Brasil
| | | |
Collapse
|
5
|
Bond P, Smit DL, de Ronde W. Anabolic-androgenic steroids: How do they work and what are the risks? Front Endocrinol (Lausanne) 2022; 13:1059473. [PMID: 36644692 PMCID: PMC9837614 DOI: 10.3389/fendo.2022.1059473] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
Anabolic-androgenic steroids (AAS) are a class of hormones that are widely abused for their muscle-building and strength-increasing properties in high, nontherapeutic, dosages. This review provides an up-to-date and comprehensive overview on how these hormones work and what side effects they might elicit. We discuss how AAS are absorbed into the circulation after intramuscular injection or oral ingestion and how they are subsequently transported to the tissues, where they will move into the extravascular compartment and diffuse into their target cells. Inside these cells, AAS can biotransform into different metabolites or bind to their cognate receptor: the androgen receptor. AAS and their metabolites can cause side effects such as acne vulgaris, hypertension, hepatotoxicity, dyslipidemia, testosterone deficiency, erectile dysfunction, gynecomastia, and cardiomyopathy. Where applicable, we mention treatment options and self-medication practices of AAS users to counteract these side effects. Clinicians may use this review as a guide for understanding how AAS use can impact health and to assist in patient education and, in some cases, the management of side effects.
Collapse
Affiliation(s)
| | - Diederik L. Smit
- Department of Internal Medicine, Elisabeth-TweeSteden Hospital, Tilburg, Netherlands
| | - Willem de Ronde
- Department of Internal Medicine, Spaarne Gasthuis, Haarlem, Netherlands
| |
Collapse
|
6
|
Gagnon LR, Sadasivan C, Perera K, Oudit GY. Cardiac Complications of Common Drugs of Abuse: Pharmacology, Toxicology and Management. Can J Cardiol 2021; 38:1331-1341. [PMID: 34737034 DOI: 10.1016/j.cjca.2021.10.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 10/16/2021] [Accepted: 10/18/2021] [Indexed: 12/23/2022] Open
Abstract
Cardiovascular complications from drugs of abuse are becoming more apparent due to increased usage worldwide. Substance abuse can cause both acute and chronic cardiovascular complications and is increasing in prevalence especially in young adults. These substances contribute to the development of acute coronary syndrome, type II myocardial injury, arrhythmias, cardiomyopathies and have numerous other cardiovascular complications. Although no screening guidelines exist, clinical awareness of these potential complications and their prevention, clinical presentation, diagnosis, and treatment are critically important. Management of cardiovascular disease should be coupled with appropriate social and mental health interventions to provide sustained clinical benefit. The higher the number of substances used recreationally, the greater the risk of premature heart disease. Epidemiological studies showed that 1 in 5 young adults misuse several substances and often start using at younger ages with a greater risk for adverse health outcomes over the long-term. The aim of this review is to highlight the basic epidemiology, cardiac complications, and disease-specific treatment options of commonly abused substances including methamphetamine, cocaine, alcohol, anabolic-androgenic steroids, cannabis, and tobacco.
Collapse
Affiliation(s)
- Luke R Gagnon
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Chandu Sadasivan
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Kevin Perera
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Gavin Y Oudit
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada.
| |
Collapse
|
7
|
Coimbra MA, Barbosa FS, Scheid C, Macedo SMD, Yonamine M, Merib JO, Oliveira TF, Eller S. Mass spectrometry determination of seized oil-based anabolic-androgenic steroids products. Forensic Sci Int 2021; 328:111012. [PMID: 34587560 DOI: 10.1016/j.forsciint.2021.111012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/11/2021] [Accepted: 09/18/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The presence of anabolic-androgenic steroids (AAS) in illegal commercial products has been pointed as a global threat for public health. Due the correlation with adverse toxicological effects, there is a growing interest in the implementation of straightforward methods for the determination of AAS in seized products. This work exploited the development of a mass spectrometry approach to characterize the illegal oil formulations containing AAS. METHODS The optimization of sample preparation was performed through a simplex-centroid design and the best condition was described as follow: an aliquot of 5 μL of sample were added with 995 μL of acetonitrile and water (75:25, v/v). The solution was vortexed and centrifuged. After that, 10 μL of supernatant were added with 35 μL of acetonitrile and water and internal standard (testosterone-d3, 1.25 ng). An aliquot of 5 μL was injected into the analytical system. RESULTS The method developed was validated and successfully applied in 115 seized samples. Testosterone and its esters had the highest incidence, found in more than 50% of the samples. Besides that, drugs such as boldenone, methandienone, and trenbolone have also been found, where the low quality of the samples was evidenced by the wide variation in the concentration of the drugs, always quantified in sub-doses. Finally, at least one AAS was detected in each sample analyzed. The statistical results were grouped by principal components analysis, to better understand the profile of the seized samples. CONCLUSION This work successfully established a fast and simple method for determination of AAS and can be applied to verify the profile of seized samples.
Collapse
Affiliation(s)
- Masurquede A Coimbra
- Pharmacosciences Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Fábio S Barbosa
- Pharmacosciences Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Camila Scheid
- Pharmacosciences Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Sandra M D Macedo
- Pharmacosciences Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil; Instituto Nacional de Ciência e Tecnologia Forense (INCT Forense), Porto Alegre, Brazil
| | - Mauricio Yonamine
- School of Pharmaceutical Sciences, University of São Paulo, São Paulo, SP 05508-000, Brazil
| | - Josias O Merib
- Pharmacosciences Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Tiago F Oliveira
- Pharmacosciences Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil.
| | - Sarah Eller
- Pharmacosciences Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil.
| |
Collapse
|
8
|
de Souza FR, Dos Santos MR, Rochitte CE, Dos Santos RP, Jordão CP, Leite IS, da Fonseca GWP, Fonseca RA, de Oliveira TF, Yonamine M, Pereira RMR, Negrão CE, Alves DNNMJ. Decreased Native T1 Values and Impaired Myocardial Contractility in Anabolic Steroid Users. Int J Sports Med 2021; 43:183-191. [PMID: 34341973 DOI: 10.1055/a-1518-7953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Anabolic androgenic steroid (AAS) abuse leads to myocardial toxicity. Human studies are conflicting about the myocardial fibrosis in AAS users. We evaluated cardiac tissue characterization, left ventricle (LV) function, and cardiac structure by cardiovascular magnetic resonance (CMR). Twenty strength-trained AAS users (AASU) aged 29±5 yr, 20 strength-trained AAS nonusers (AASNU), and 7 sedentary controls (SC) were enrolled. Native T1 mapping, late-gadolinium enhancement (LGE), extracellular volume (ECV), and myocardial strain were evaluated. AASU showed lower Native T1 values than AASNU (888±162 vs. 1020±179 ms p=0.047). Focal myocardial fibrosis was found in 2 AASU. AASU showed lower LV radial strain (30±8 vs. 38±6%, p<0.01), LV circumferential strain (-17±3 vs. -20±2%, p<0.01), and LV global longitudinal strain (-17±3 vs. -20±3%, p<0.01) than AASNU by CMR. By echocardiography, AASU demonstrated lower 4-chamber longitudinal strain than AASNU (-15±g3 vs. -18±2%, p=0.03). ECV was similar among AASU, AASNU, and SC (28±10 vs. 28±7 vs. 30±7%, p=0.93). AASU had higher LV mass index than AASNU and SC (85±14 vs. 64±8 vs. 58±5 g/m2, respectively, p<0.01). AAS abuse may be linked to decreased myocardial native T1 values, impaired myocardial contractility, and focal fibrosis. These alterations may be associated with maladaptive cardiac hypertrophy in young AAS users.
Collapse
Affiliation(s)
- Francis Ribeiro de Souza
- Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Marcelo Rodrigues Dos Santos
- Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Carlos Eduardo Rochitte
- Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Rafael Parenquine Dos Santos
- Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Camila Paixão Jordão
- Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Ivanhoe Stuart Leite
- Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Rafael Almeida Fonseca
- Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Tiago Franco de Oliveira
- Departamento de Farmacociências da Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | - Maurício Yonamine
- Departamento de Análises Clínicas e Toxicológicas da Faculdade de Ciências Farmacêuticas da Universidade de São Paulo, São Paulo, Brazil
| | - Rosa Maria Rodrigues Pereira
- Laboratório de Metabolismo Ósseo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Carlos Eduardo Negrão
- Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.,Escola de Educação Física e Esporte da Universidade de São Paulo, São Paulo, Brazil
| | | |
Collapse
|
9
|
El Deib MM, El-Sharkawy NI, Beheiry RR, Abd-Elhakim YM, Ismail SA, Fahmy EM, Saber T, Saber TM. Boldenone undecylenate disrupts the immune system and induces autoimmune clinical hypothyroidism in rats: Vitamin C ameliorative effects. Int Immunopharmacol 2021; 99:107939. [PMID: 34224995 DOI: 10.1016/j.intimp.2021.107939] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/07/2021] [Accepted: 06/28/2021] [Indexed: 12/20/2022]
Abstract
The present study was designed to evaluate the effects of boldenone undecylenate (BL) abuse alone and in combination with vitamin C (VC) on the immune responses and thyroid structure and function in rats. Thirty adult male Wistar rats were randomly divided into five equal groups and were subjected to various treatment regimens for eight weeks as follows: control group, vehicle control group, VC group orally received VC (120 mg/Kg BW/day), BL-treated group intramuscularly injected with BL (5 mg/kg BW, once/week), and BL+VC group received BL and VC. At the end of this experiment, blood and tissue samples (thyroid, thymus, and spleen) were subjected to hematological evaluation, biochemical analysis, histopathological, and immunohistochemical examinations. In comparison to controls, BL significantly increased the levels of serum proinflammatory interleukins (IL-1 β and IL-6), immunoglobulins (IgG and IgM), and complement 3 but reduced anti-inflammatory interleukin-10, lysosome, and nitric oxide. Besides, altered platelet count and leukogram were evident in BL-injected rats. BL notably disturbed thyroid profile as revealed by a significant increase of thyroid-stimulating hormone and thyroid peroxidase antibody. In contrast, both total and free forms of thyroid hormones (tri-iodothyronine and thyroxine), thyroglobulin, and thyroid peroxidase, were significantly decreased. Moreover, BL caused histopathological changes in the thyroid, thymus, and spleen tissues.CD4+ immuno-expression was reduced, but CD8+ immunolabelling was increased in both spleen and thymus. The daily dosing of VC to BL-exposed rats significantly corrected most of the deviations in immune parameters. It restored most of the thyroid architecture and function, revealing a significant protective effect of this vitamin. This experimental study demonstrates that BL abusing disrupts the immune system by different mechanisms and addresses BL, for the first time, as an autoimmune clinical hypothyroidism inducer drug. Additionally, VC is helpful in the management of BL abuse.
Collapse
Affiliation(s)
- Maha M El Deib
- Department of Biochemistry, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Nabela I El-Sharkawy
- Department of Forensic Medicine and Toxicology Faculty of Veterinary Medicine, Zagazig University, Egypt
| | - Rasha R Beheiry
- Department of Histology and Cytology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Yasmina M Abd-Elhakim
- Department of Forensic Medicine and Toxicology Faculty of Veterinary Medicine, Zagazig University, Egypt.
| | - Shimaa Aa Ismail
- Department of Clinical Pathology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Esraa M Fahmy
- Department of Pharmacology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Taisir Saber
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Taghred M Saber
- Department of Forensic Medicine and Toxicology Faculty of Veterinary Medicine, Zagazig University, Egypt
| |
Collapse
|
10
|
Corona G, Rastrelli G, Marchiani S, Filippi S, Morelli A, Sarchielli E, Sforza A, Vignozzi L, Maggi M. Consequences of Anabolic-Androgenic Steroid Abuse in Males; Sexual and Reproductive Perspective. World J Mens Health 2021; 40:165-178. [PMID: 34169679 PMCID: PMC8987149 DOI: 10.5534/wjmh.210021] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/05/2021] [Accepted: 04/05/2021] [Indexed: 11/25/2022] Open
Abstract
The real epidemiology and the possible consequences of anabolic-androgenic steroids (AAS) use still represent a very tricky task due to the difficulties in the quantification and detection of these drugs. Chronic use of AAS, frequently combined with other illicit substances, can induce tremendous negative effects on the reproductive system, but it is also associated with an increased overall and cardiovascular mortality risk. In the present review we summarize and discuss the available evidence regarding the negative impact of AAS on the male reproductive system, providing practical suggestions to manage these problems. For this purpose a meta-analysis evaluating the effects of AAS abusers vs. controls on several hormonal, reproductive and metabolic parameters was performed. In addition, in order to overcome possible limitations related to the combined use of different AAS preparations, we also retrospectively re-analyzed data on animal models treated with supraphysiological dosage of testosterone (T), performed in our laboratory. Available data clearly indicated that AAS negatively affect endogenous T production. In addition, increased T and estradiol circulating levels were also observed according to the type of preparations used. The latter leads to an impairment of sperm production and to the development of side effects such as acne, hair loss and gynecomastia. Furthermore, a worse metabolic profile, characterized by reduced high density lipoprotein and increased low density lipoprotein cholesterol levels along with an increased risk of hypertension has been also detected. Finally sexual dysfunctions, often observed upon doping, represent one the most probable unfavorable effects of AAS abuse.
Collapse
Affiliation(s)
- Giovanni Corona
- Endocrinology Unit, Medical Department, Azienda-Usl Bologna, Maggiore-Bellaria Hospital, Bologna, Italy.
| | - Giulia Rastrelli
- Andrology, Female Endocrinology and Gender Incongruence Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy
| | - Sara Marchiani
- Andrology, Female Endocrinology and Gender Incongruence Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy
| | - Sandra Filippi
- Andrology, Female Endocrinology and Gender Incongruence Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy
| | - Annamaria Morelli
- Section of Human Anatomy and Histology, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Erica Sarchielli
- Section of Human Anatomy and Histology, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Alessandra Sforza
- Endocrinology Unit, Medical Department, Azienda-Usl Bologna, Maggiore-Bellaria Hospital, Bologna, Italy
| | - Linda Vignozzi
- Andrology, Female Endocrinology and Gender Incongruence Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy
| | - Mario Maggi
- Endocrinology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy
| |
Collapse
|
11
|
van Velzen DM, Adorni MP, Zimetti F, Strazzella A, Simsek S, Sirtori CR, Heijer MD, Ruscica M. The effect of transgender hormonal treatment on high density lipoprotein cholesterol efflux capacity. Atherosclerosis 2021; 323:44-53. [PMID: 33836456 DOI: 10.1016/j.atherosclerosis.2021.03.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 02/25/2021] [Accepted: 03/10/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIMS A decrease in high-density lipoprotein (HDL)-cholesterol concentrations during transgender hormone therapy has been shown. However, the ability of HDL to remove cholesterol from arterial wall macrophages, termed cholesterol efflux capacity (CEC), has proven to be a better predictor of cardiovascular disease (CVD) largely independently of HDL-concentrations. In addition, the serum capacity to load macrophages with cholesterol (cholesterol loading capacity, CLC) represents an index of pro-atherogenic potential. As transgender individuals are exposed to lifelong exogenous hormone therapy (HT), it becomes of interest to study whether HDL-CEC and serum CLC are affected by HT. HDL-CEC and serum CLC have been evaluated in 15 trans men treated with testosterone and in 15 trans women treated with estradiol and cyproterone acetate at baseline and after 12 months of HT. METHODS Total HDL-CEC from macrophages and its major contributors, the ATP-binding cassette transporters (ABC) A1 and ABCG1 HDL-CEC and HDL-CEC by aqueous diffusion were determined by a radioisotopic assay. CLC was evaluated in human THP-1 macrophages. RESULTS In trans women, total HDL-CEC decreased by 10.8% (95%CI: -14.3;-7.3; p < 0.001), ABCA1 HDL-CEC by 23.8% (-34.7; -12.9; p < 0.001) and aqueous diffusion HDL-CEC by 4.8% (-8.4;-1.1; p < 0.01). In trans men, only aqueous diffusion HDL-CEC decreased significantly, -9.8% (-15.7;-3.9; p < 0.01). ABCG1 HDL-CEC did not change in either group. Serum CLC and HDL subclass distribution were not modified by HT in both groups. CONCLUSIONS Total HDL-CEC decreased during HT in trans women, with a specific reduction in ABCA1 CEC. This finding might contribute to a higher CVD risk.
Collapse
Affiliation(s)
- Daan M van Velzen
- Department of Internal Medicine, Division of Endocrinology, Amsterdam University Medical Center, Amsterdam, the Netherlands.
| | - Maria Pia Adorni
- Dipartimento di Medicina e Chirurgia, Unità di Neuroscienze, Università di Parma, Parma, Italy
| | | | - Arianna Strazzella
- Center E. Grossi Paoletti, Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milano, Italy
| | - Suat Simsek
- Department of Internal Medicine, Division of Endocrinology, Amsterdam University Medical Center, Amsterdam, the Netherlands; Department of Endocrinology, Northwest Clinics, Alkmaar, the Netherlands
| | - Cesare R Sirtori
- Department of Pharmacology and Biomolecular Sciences, Università degli Studi di Milano, Milano, Italy
| | - Martin den Heijer
- Department of Internal Medicine, Division of Endocrinology, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Massimiliano Ruscica
- Department of Pharmacology and Biomolecular Sciences, Università degli Studi di Milano, Milano, Italy
| |
Collapse
|
12
|
Lee MT, Mahtta D, Alam M, Ullah W, Nasir K, Hanif B, Virani SS. Contemporary outcomes studies to identify and mitigate the risk in patients with premature cardiovascular disease. Expert Rev Pharmacoecon Outcomes Res 2021; 21:559-570. [DOI: 10.1080/14737167.2021.1888718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Michelle T. Lee
- Health Policy, Quality & Informatics Program, Michael E. DeBakey VA Medical Center Health Services Research & Development Center for Innovations in Quality, Effectiveness, and Safety, Houston, TX, USA
- Section of Health Services Research, Department of Medicine, Baylor College of Medicine, USA
| | - Dhruv Mahtta
- Health Policy, Quality & Informatics Program, Michael E. DeBakey VA Medical Center Health Services Research & Development Center for Innovations in Quality, Effectiveness, and Safety, Houston, TX, USA
- Section of Health Services Research, Department of Medicine, Baylor College of Medicine, USA
- Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, USA
| | - Mahboob Alam
- Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, USA
| | - Waqas Ullah
- Department of Internal Medicine, Abington Jefferson Health, Abington, PA, USA
| | - Khurram Nasir
- Department of Cardiology, Center for Outcomes Research, Houston Methodist Hospital, Houston, TX, USA
- Division of Cardiovascular Prevention and Wellness, Methodist DeBakey Heart & Vascular Center, Houston, TX, USA
| | - Bashir Hanif
- Section of Cardiology, Tabba Heart Institute, Karachi, Pakistan
| | - Salim S. Virani
- Health Policy, Quality & Informatics Program, Michael E. DeBakey VA Medical Center Health Services Research & Development Center for Innovations in Quality, Effectiveness, and Safety, Houston, TX, USA
- Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, USA
- Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, USA
| |
Collapse
|
13
|
Heydari A, Asadmobini A, Sabzi F. Anabolic Steroid Use and Aortic Dissection in Athletes: A Case Series. Oman Med J 2020; 35:e179. [PMID: 33083037 PMCID: PMC7568822 DOI: 10.5001/omj.2020.120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 08/08/2019] [Indexed: 11/06/2022] Open
Abstract
The use of anabolic steroids in supraphysiologic doses has grown in the last decade as doping drugs in athletes. The high dose of anabolic-androgenic steroids (AAS) causes cardiomyopathy, hypertension, thrombosis, myocardial infarction (MI), weakness of connective tissue, and its sequelae such as tendon injury and aortic dissection. Dissection of the ascending aorta is an uncommon injury that has been recognized with increasing frequency in bodybuilders in recent years. It has been proposed that such cases commonly accompany the weakening of connective tissue and must be actively evaluated in the presence of anabolic steroid usage. We present a case series of isolated ascending aorta dissection in athletes who were bodybuilders. All cases were evaluated by transthoracic echocardiography (TTE) and laboratory exams. These cases also served as a reminder of the risks of ascending aorta dissection with AAS, especially in strength athletes who place high demands on their musculoskeletal structures. The results of the current study suggested that anabolic steroid abuse may be associated with detrimental effects on the myocardium represented as cardiomyopathy or atherosclerotic changes in the coronary artery as MI. These findings also strongly suggest that anabolic steroid treatment predisposes the individual to aortic dissection, especially when the patients are exercised.
Collapse
Affiliation(s)
- Aghigh Heydari
- Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Atefeh Asadmobini
- Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Feridoun Sabzi
- Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| |
Collapse
|
14
|
Perry JC, Schuetz TM, Memon MD, Faiz S, Cancarevic I. Anabolic Steroids and Cardiovascular Outcomes: The Controversy. Cureus 2020; 12:e9333. [PMID: 32850208 PMCID: PMC7444848 DOI: 10.7759/cureus.9333] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Anabolic steroids (AS) are synthetic derivatives of the male sex hormone testosterone. The use of AS is not limited to bodybuilders and athletes, but non-athletes also use them. It is used to enhance athletic performance, induce muscle hypertrophy, and augment male sexual characteristics. AS use is associated with a wide range of side effects and potential cardiovascular complications. In this article, we have searched the available literature to investigate the association between AS use and cardiovascular disease (CVD). The results revealed that AS was linked to lipid metabolism derangements, hypertension, coagulation disorders, and cardiomyopathy. We concluded, based on the relevant data, that there was evidence that suggests an association with CVD, primarily myocardial infarction, fatal arrhythmias, and cardiomyopathy in AS users. The general population should be informed of the risk. Also, methods of primary and secondary prevention should be implemented to mitigate the risk of CVD secondary to AS.
Collapse
Affiliation(s)
- Jamal C Perry
- Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Tayná M Schuetz
- Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Mohammad D Memon
- Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Sadaf Faiz
- Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Ivan Cancarevic
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| |
Collapse
|
15
|
Binder CJ, Borén J, Catapano AL, Dallinga-Thie G, Kronenberg F, Mallat Z, Negrini S, Raggi P, von Eckardstein A. The year 2019 in Atherosclerosis. Atherosclerosis 2020; 299:67-75. [PMID: 32248950 DOI: 10.1016/j.atherosclerosis.2020.03.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Christoph J Binder
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Jan Borén
- Department of Molecular and Clinical Medicine, Wallenberg Laboratory, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Alberico L Catapano
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy; IRCCS Multimedica Hospital, Milan, Italy
| | - Geesje Dallinga-Thie
- Department of Vascular Medicine, Amsterdam University Medical Centers, AMC, Amsterdam, the Netherlands
| | - Florian Kronenberg
- Institute of Genetic Epidemiology, Department of Genetics and Pharmacology, Medical University of Innsbruck, Austria
| | - Ziad Mallat
- Department of Medicine, Division of Cardiovascular Medicine, University of Cambridge, Cambridge, United Kingdom; University of Paris, PARCC, INSERM, Paris, France
| | - Simona Negrini
- Institute of Clinical Chemistry, University of Zurich, University Hospital of Zurich, Zurich, Switzerland
| | - Paolo Raggi
- Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, AB, Canada; Department of Medicine, University of Alberta, Edmonton, AB, Canada; Division of Cardiology, University of Alberta, Edmonton, AB, Canada
| | - Arnold von Eckardstein
- Institute of Clinical Chemistry, University of Zurich, University Hospital of Zurich, Zurich, Switzerland.
| |
Collapse
|
16
|
de Sousa ELH, Cavalcante JEA, de Sousa DF, Ferreira JM, Meneses RRC, Sousa DL, da Silva AJX, Filho RRBX, da Silva Dos Santos E, Havt A, Damasceno NRT, Sampaio TL, Queiroz MGR. Comparison of early cardiovascular risk among Brazilian and African university students. Clin Biochem 2019; 75:7-14. [PMID: 31678428 DOI: 10.1016/j.clinbiochem.2019.09.007] [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: 07/09/2019] [Revised: 09/12/2019] [Accepted: 09/16/2019] [Indexed: 12/25/2022]
Abstract
Cardiovascular diseases are among the main causes of mortality worldwide, and dyslipidemia is a principal factor risk. Hence the study of biochemical markers is necessary for early diagnosis. OBJECTIVES Evaluate biomarkers to diagnose the risks of cardiovascular diseases in healthy Brazilian and African young adults. DESIGN & METHODS Weight, height, waist circumference, percentage of body fat and systemic blood pressure were measured; and fasting blood samples were taken for biochemical analysis. Triglycerides, total cholesterol, HDL-c, and apolipoproteins A-I and B were measured on automated equipment using commercially available kits, in addition to the tests of antioxidant capacity of HDL and the enzymatic activity of Paraoxonase 1. RESULTS After statistical analysis, it was found that BMI, WC, fat (%), triglycerides, ApoB/ApoA-I ratio and Vmax were higher in Brazilians, while HDL-c, ApoA-I, Lag Time, Vmax and PON1 activity were higher in Africans. In Brazilians, the ApoB/ApoA-I ratio was related to obesity factors and lipid profile, but in Africans it was related only to lipids. The antioxidant capacity of HDL and PON1 activity was better in Africans. Through independence testing, we observed an association with moderate risk of myocardial infarction with gender in Africans. In the binary logistic regression analysis, it was found that men in general - and particularly African men - have higher risk of myocardial infarction than women; Odds Ratio 2144 (CI95%: 1343-3424) and 2281 (CI95%: 1082-4811), respectively. CONCLUSIONS The anthropometric and biochemical parameters of Brazilians, especially men, predispose them to greater risks of cardiovascular diseases.
Collapse
Affiliation(s)
| | | | | | | | | | - Duaran Lopes Sousa
- Department of Clinical and Toxicological Analysis, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | | | | | - Elias da Silva Dos Santos
- Department of Clinical and Toxicological Analysis, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Alexandre Havt
- Department of Physiology and Pharmacology, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | | | - Tiago Lima Sampaio
- Department of Clinical and Toxicological Analysis, Federal University of Ceará, Fortaleza, Ceará, Brazil.
| | | |
Collapse
|