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1
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Sinha A, Deb VK, Datta A, Yadav S, Phulkar A, Adhikari S. Evaluation of structural features of anabolic-androgenic steroids: entanglement for organ-specific toxicity. Steroids 2024; 212:109518. [PMID: 39322097 DOI: 10.1016/j.steroids.2024.109518] [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: 07/02/2024] [Revised: 09/16/2024] [Accepted: 09/20/2024] [Indexed: 09/27/2024]
Abstract
Anabolic-androgenic steroids (AASs), more correctly termed "steroidal androgens", are a broad category of compounds including both synthetic derivatives and endogenously produced androgens like testosterone, which have long been employed as performance-enhancing substances, primarily among recreational athletes and some professionals. While their short-term effects on muscle physiology are well-documented, the long-term health consequences remain inadequately understood. A key finding is the disruption of hormone production, leading to reversible and irreversible changes, particularly with prolonged use. While debate exists over the prevalence of adverse effects, studies suggest a spectrum of somatic and psychiatric consequences, highlighting the need for improved understanding and prevention strategies. AASs are not only affect muscle structure but also influence mood, behavior, and body image, potentially exacerbating substance dependence and psychological distress. Liver alterations are a prominent concern, with oxidative stress implicated in AAS-induced hepatotoxicity. Reproductive complications, including gonadal atrophy and infertility, are common, alongside virilization and feminization effects in both genders. Cardiovascular effects are particularly worrisome, with AASs implicated in hypertension, dyslipidemia, and increased thrombotic risk, contributing to cardiovascular morbidity and mortality. Moreover, AASs may enhance cancer risks, potentially accelerating carcinogenesis in various tissues, including the prostate. The review emphasizes the need for comprehensive public health initiatives to mitigate harm, including harm minimization strategies, routine health screenings, and targeted interventions for AAS users. Understanding the complex interplay of biological mechanisms and systemic effects is crucial for informing clinical management and preventive measures. This review also examines the biological impact of AASs on human muscles, detailing mechanisms of action, chemistry, and associated health risks such as liver damage, cardiovascular disease, and endocrine dysfunction.
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Affiliation(s)
- Ankan Sinha
- Department of Physical Education, Govt. Degree College, Dharmanagar, Tripura(N) 799253, India.
| | - Vishal Kumar Deb
- School of Health Sciences and Technology, UPES, Dehradun 248007, Uttarakhand, India
| | - Abhijit Datta
- Department of Botany, Ambedkar College, Fatikroy, Unakoti 799290 Tripura, India
| | - Satpal Yadav
- Department of Sports Biomechanics, LNIPE, NERC, Guwahati 782402 Assam, India
| | - Ashish Phulkar
- Department of Sports Management and Coaching, LNIPE, Gwalior 474002, Madhya Pradesh, India
| | - Suman Adhikari
- Department of Chemistry, Govt. Degree College, Dharmanagar, Tripura(N) 799253, India.
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2
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Norman C, Harries RL, Reid R, Nisbet LA, Nic Daéid N. Changing trends in anabolic-androgenic steroid use within Scottish prisons: Detection, prevalence, and quantitation. Drug Test Anal 2024. [PMID: 39162327 DOI: 10.1002/dta.3790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 08/01/2024] [Accepted: 08/02/2024] [Indexed: 08/21/2024]
Abstract
Anabolic-androgenic steroids (AASs) are a subclassification of image performance enhancing drugs (IPEDs). While AAS use is most prevalent among people in athletics, there is also high lifetime prevalence of AAS use among prisoners. This study reports the qualitative detection of AASs in seized samples from the Scottish prisons from 2019-2023. Additionally, methods were developed for the quantitative analysis of AASs using gas chromatography-mass spectrometry (GC-MS) and applied to 61 samples of tablets or powders seized from Scottish prisons between July 2022 and July 2023. Since 2022, there has been an increase in AAS detections in the Scottish prisons. Oxymetholone was the most prevalent AAS, followed by metandienone (methandrostenolone, methandienone), methyltestosterone, oxandrolone, mestanolone (methylandrostanolone), stanozolol, and androstenedione. Multiple AASs were found in 21 samples and 10 samples contained other drugs, including amitriptyline, sertraline, zopiclone, mirtazapine, sildenafil, etizolam, Δ9-tetrahydrocannabinol, and the synthetic cannabinoid MDMB-INACA. Most AAS samples were tablets (77.0%), although they were also detected in powders, herbal material, e-cigarettes, and a fragmented soap bar-type sample. There was a large variation in the concentration of AASs in the tablets and powders seized from the Scottish prisons, demonstrating AASs are another highly variable component of the polydrug use situation in prisons, the effects of which need to be examined further.
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Affiliation(s)
- Caitlyn Norman
- Leverhulme Research Centre for Forensic Science, School of Science and Engineering, University of Dundee, Dundee, UK
- Division of Clinical Chemistry and Pharmacology, Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Richard L Harries
- Leverhulme Research Centre for Forensic Science, School of Science and Engineering, University of Dundee, Dundee, UK
| | - Robert Reid
- Leverhulme Research Centre for Forensic Science, School of Science and Engineering, University of Dundee, Dundee, UK
| | - Lorna A Nisbet
- Leverhulme Research Centre for Forensic Science, School of Science and Engineering, University of Dundee, Dundee, UK
| | - Niamh Nic Daéid
- Leverhulme Research Centre for Forensic Science, School of Science and Engineering, University of Dundee, Dundee, UK
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Miele C, Mennitti C, Gentile A, Veneruso I, Scarano C, Vastola A, La Monica I, Uomo F, Iafusco F, Capasso F, Pero R, D’Argenio V, Lombardo B, Tinto N, Di Micco P, Scudiero O, Frisso G, Mazzaccara C. Thrombosis and Thrombotic Risk in Athletes. J Clin Med 2024; 13:4881. [PMID: 39201023 PMCID: PMC11355105 DOI: 10.3390/jcm13164881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 08/13/2024] [Accepted: 08/14/2024] [Indexed: 09/02/2024] Open
Abstract
The hemostatic system is characterized by a delicate balance between pro- and anticoagulant forces, and the smallest alteration can cause serious events such as hemorrhages or thrombosis. Although exercise has been shown to play a protective role in athletes, several factors may increase the risk of developing venous thromboembolism (VTE), including hemoconcentration induced by exertion, immobilization following sports injuries, frequent long-distance flights, dehydration, and the use of oral contraceptives in female athletes. Biomarkers such as D-dimer, Factor VIII, thrombin generation, inflammatory cytokines, and leukocyte count are involved in the diagnosis of deep vein thrombosis (DVT), although their interpretation is complex and may indicate the presence of other conditions such as infections, inflammation, and heart disease. Therefore, the identification of biomarkers with high sensitivity and specificity is needed for the screening and early diagnosis of thromboembolism. Recent evidence about the correlation between the intensity of physical activity and VTE is divergent, whereas the repeated gestures in sports such as baseball, hockey, volleyball, swimming, wrestling, or, on the other hand, soccer players, runners, and martial art training represent a risk factor predisposing to the onset of upper and lower DVT. Anticoagulant therapy is the gold standard, reducing the risk of serious complications such as pulmonary embolism. The aim of this review is to provide a general overview about the interplay between physical exercise and the risk of thromboembolism in athletes, focusing on the main causes of thrombosis in professional athletes and underlying the need to identify new markers and therapies that can represent a valid tool for safeguarding the athlete's health.
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Affiliation(s)
- Ciro Miele
- Department of Molecular Medicine and Medical Biotechnologies, Federico II University, Via Sergio Pansini 5, 80131 Napoli, Italy; (C.M.); (C.M.); (A.G.); (I.V.); (C.S.); (A.V.); (F.U.); (R.P.); (B.L.); (N.T.); (G.F.); (C.M.)
- UOC Laboratory Medicine, Haematology and Laboratory Haemostasis and Special Investigations, AOU Federico II University of Naples, 80131 Naples, Italy;
- CEINGE-Biotecnologie Avanzate Franco Salvatore, Via G. Salvatore 486, 80145 Napoli, Italy; (I.L.M.); (F.I.); (V.D.)
| | - Cristina Mennitti
- Department of Molecular Medicine and Medical Biotechnologies, Federico II University, Via Sergio Pansini 5, 80131 Napoli, Italy; (C.M.); (C.M.); (A.G.); (I.V.); (C.S.); (A.V.); (F.U.); (R.P.); (B.L.); (N.T.); (G.F.); (C.M.)
| | - Alessandro Gentile
- Department of Molecular Medicine and Medical Biotechnologies, Federico II University, Via Sergio Pansini 5, 80131 Napoli, Italy; (C.M.); (C.M.); (A.G.); (I.V.); (C.S.); (A.V.); (F.U.); (R.P.); (B.L.); (N.T.); (G.F.); (C.M.)
| | - Iolanda Veneruso
- Department of Molecular Medicine and Medical Biotechnologies, Federico II University, Via Sergio Pansini 5, 80131 Napoli, Italy; (C.M.); (C.M.); (A.G.); (I.V.); (C.S.); (A.V.); (F.U.); (R.P.); (B.L.); (N.T.); (G.F.); (C.M.)
- CEINGE-Biotecnologie Avanzate Franco Salvatore, Via G. Salvatore 486, 80145 Napoli, Italy; (I.L.M.); (F.I.); (V.D.)
| | - Carmela Scarano
- Department of Molecular Medicine and Medical Biotechnologies, Federico II University, Via Sergio Pansini 5, 80131 Napoli, Italy; (C.M.); (C.M.); (A.G.); (I.V.); (C.S.); (A.V.); (F.U.); (R.P.); (B.L.); (N.T.); (G.F.); (C.M.)
- CEINGE-Biotecnologie Avanzate Franco Salvatore, Via G. Salvatore 486, 80145 Napoli, Italy; (I.L.M.); (F.I.); (V.D.)
| | - Aniello Vastola
- Department of Molecular Medicine and Medical Biotechnologies, Federico II University, Via Sergio Pansini 5, 80131 Napoli, Italy; (C.M.); (C.M.); (A.G.); (I.V.); (C.S.); (A.V.); (F.U.); (R.P.); (B.L.); (N.T.); (G.F.); (C.M.)
| | - Ilaria La Monica
- CEINGE-Biotecnologie Avanzate Franco Salvatore, Via G. Salvatore 486, 80145 Napoli, Italy; (I.L.M.); (F.I.); (V.D.)
| | - Fabiana Uomo
- Department of Molecular Medicine and Medical Biotechnologies, Federico II University, Via Sergio Pansini 5, 80131 Napoli, Italy; (C.M.); (C.M.); (A.G.); (I.V.); (C.S.); (A.V.); (F.U.); (R.P.); (B.L.); (N.T.); (G.F.); (C.M.)
| | - Fernanda Iafusco
- CEINGE-Biotecnologie Avanzate Franco Salvatore, Via G. Salvatore 486, 80145 Napoli, Italy; (I.L.M.); (F.I.); (V.D.)
| | - Filomena Capasso
- UOC Laboratory Medicine, Haematology and Laboratory Haemostasis and Special Investigations, AOU Federico II University of Naples, 80131 Naples, Italy;
| | - Raffaela Pero
- Department of Molecular Medicine and Medical Biotechnologies, Federico II University, Via Sergio Pansini 5, 80131 Napoli, Italy; (C.M.); (C.M.); (A.G.); (I.V.); (C.S.); (A.V.); (F.U.); (R.P.); (B.L.); (N.T.); (G.F.); (C.M.)
- Task Force on Microbiome Studies, University of Naples Federico II, 80100 Naples, Italy
| | - Valeria D’Argenio
- CEINGE-Biotecnologie Avanzate Franco Salvatore, Via G. Salvatore 486, 80145 Napoli, Italy; (I.L.M.); (F.I.); (V.D.)
- Department of Human Sciences and Quality of Life Promotion, San Raffaele Open University, 00100 Rome, Italy
| | - Barbara Lombardo
- Department of Molecular Medicine and Medical Biotechnologies, Federico II University, Via Sergio Pansini 5, 80131 Napoli, Italy; (C.M.); (C.M.); (A.G.); (I.V.); (C.S.); (A.V.); (F.U.); (R.P.); (B.L.); (N.T.); (G.F.); (C.M.)
- CEINGE-Biotecnologie Avanzate Franco Salvatore, Via G. Salvatore 486, 80145 Napoli, Italy; (I.L.M.); (F.I.); (V.D.)
| | - Nadia Tinto
- Department of Molecular Medicine and Medical Biotechnologies, Federico II University, Via Sergio Pansini 5, 80131 Napoli, Italy; (C.M.); (C.M.); (A.G.); (I.V.); (C.S.); (A.V.); (F.U.); (R.P.); (B.L.); (N.T.); (G.F.); (C.M.)
- CEINGE-Biotecnologie Avanzate Franco Salvatore, Via G. Salvatore 486, 80145 Napoli, Italy; (I.L.M.); (F.I.); (V.D.)
| | - Pierpaolo Di Micco
- AFO Medicina, P.O. Santa Maria delle Grazie, Pozzuoli, ASL Napoli2 nord, 80076 Naples, Italy
| | - Olga Scudiero
- Department of Molecular Medicine and Medical Biotechnologies, Federico II University, Via Sergio Pansini 5, 80131 Napoli, Italy; (C.M.); (C.M.); (A.G.); (I.V.); (C.S.); (A.V.); (F.U.); (R.P.); (B.L.); (N.T.); (G.F.); (C.M.)
- CEINGE-Biotecnologie Avanzate Franco Salvatore, Via G. Salvatore 486, 80145 Napoli, Italy; (I.L.M.); (F.I.); (V.D.)
- Task Force on Microbiome Studies, University of Naples Federico II, 80100 Naples, Italy
| | - Giulia Frisso
- Department of Molecular Medicine and Medical Biotechnologies, Federico II University, Via Sergio Pansini 5, 80131 Napoli, Italy; (C.M.); (C.M.); (A.G.); (I.V.); (C.S.); (A.V.); (F.U.); (R.P.); (B.L.); (N.T.); (G.F.); (C.M.)
- CEINGE-Biotecnologie Avanzate Franco Salvatore, Via G. Salvatore 486, 80145 Napoli, Italy; (I.L.M.); (F.I.); (V.D.)
| | - Cristina Mazzaccara
- Department of Molecular Medicine and Medical Biotechnologies, Federico II University, Via Sergio Pansini 5, 80131 Napoli, Italy; (C.M.); (C.M.); (A.G.); (I.V.); (C.S.); (A.V.); (F.U.); (R.P.); (B.L.); (N.T.); (G.F.); (C.M.)
- CEINGE-Biotecnologie Avanzate Franco Salvatore, Via G. Salvatore 486, 80145 Napoli, Italy; (I.L.M.); (F.I.); (V.D.)
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Zapata-Linares J, Gervasini G. Contaminants in Dietary Supplements: Toxicity, Doping Risk, and Current Regulation. Int J Sport Nutr Exerc Metab 2024; 34:232-241. [PMID: 38653450 DOI: 10.1123/ijsnem.2023-0263] [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: 11/30/2023] [Revised: 02/09/2024] [Accepted: 03/06/2024] [Indexed: 04/25/2024]
Abstract
Athletes, both amateur and professional, often resort to the consumption of nutritional supplements without professional supervision and without being aware of the risks they may entail. We conducted an exhaustive literature search to determine the most common substances found as contaminants in dietary supplements. For each substance, we analyzed its mechanism of action, clinical indication, health risk, and putative use as doping agent. In addition, we evaluated the current regulation of these supplements. Contamination of nutritional supplements (accidental or intentional), especially with steroids and stimulants, is a hazardous situation. The prolonged consumption of these products without being aware of their composition can cause serious health risks and, in the case of professional athletes, a possible sanction for doping.
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Affiliation(s)
- Jesús Zapata-Linares
- Faculty of Medicine and Health Sciences, Division of Pharmacology, Department of Medical and Surgical Therapeutics, School of Medicine and Health Sciences, University of Extremadura, Badajoz, Spain
| | - Guillermo Gervasini
- Faculty of Medicine and Health Sciences, Division of Pharmacology, Department of Medical and Surgical Therapeutics, School of Medicine and Health Sciences, University of Extremadura, Badajoz, Spain
- Instituto Universitario de Biomarcadores de Patologías Moleculares, University of Extremadura, Badajoz, Spain
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5
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Pinto TG, Malacarne IT, Takeshita WM, de Barros Viana M, Renno ACM, Ribeiro DA. Is genotoxicity a suitable biomarker for monitoring anabolic-androgenic steroids exposure in vivo? A systematic review and meta-analysis. J Appl Toxicol 2024. [PMID: 38840431 DOI: 10.1002/jat.4656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 05/22/2024] [Accepted: 05/24/2024] [Indexed: 06/07/2024]
Abstract
Steroids stand for a class of hormones (natural and synthetic) known to be helpful for a number of disorders. Despite the aforementioned beneficial effects of using these hormones, anabolic-androgenic steroids (AAS) are also widely abused in a non-therapeutic manner for muscle-building and strength-increasing properties that may lead to genotoxicity in different tissues. The present study aims to understand whether genotoxicity may be a suitable biomarker for AAS exposure in vivo in both experimental animal and human studies. All studies published in PubMed/Medline, Scopus, and Web of Science electronic databases that presented data on DNA damage caused by AAS were analyzed. A total of 15 articles were included in this study, and after thoroughly reviewing the studies, a total of 8 articles were classified as Strong, 6 were classified as Moderate, and only 1 was classified as Weak, totaling 14 studies being considered either Strong or Moderate. This classification makes it possible to consider the present findings as reliable. The meta-analysis data revealed a statistically significant difference in Wistar rat testis cells with AAS compared to control for tail length and % tail DNA (p < 0.001), so that the selected articles were considered homogeneous and the I2 of 0% indicated low heterogeneity. In summary, genotoxicity can be considered a suitable biomarker for monitoring AAS exposure as a result of DNA breakage and oxidative DNA damage.
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Affiliation(s)
- Thiago Guedes Pinto
- Department of Biosciences, Institute of Health and Society, Federal University of São Paulo, UNIFESP, Santos, SP, Brazil
| | - Ingra Tais Malacarne
- Department of Biosciences, Institute of Health and Society, Federal University of São Paulo, UNIFESP, Santos, SP, Brazil
| | - Wilton Mitsunari Takeshita
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University, UNESP, Araçatuba, SP, Brazil
| | - Milena de Barros Viana
- Department of Biosciences, Institute of Health and Society, Federal University of São Paulo, UNIFESP, Santos, SP, Brazil
| | - Ana Claudia Muniz Renno
- Department of Biosciences, Institute of Health and Society, Federal University of São Paulo, UNIFESP, Santos, SP, Brazil
| | - Daniel Araki Ribeiro
- Department of Biosciences, Institute of Health and Society, Federal University of São Paulo, UNIFESP, Santos, SP, Brazil
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Steffens D, Solomon M, Dubowitz J, Martis W, Ismail H, Koh C, Riedel B. Augmented prehabilitation - is there a role for glucocorticoids and/or anabolic steroids to improve surgical outcomes? ANZ J Surg 2024; 94:989-992. [PMID: 38525865 DOI: 10.1111/ans.18989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/12/2024] [Accepted: 03/13/2024] [Indexed: 03/26/2024]
Affiliation(s)
- Daniel Steffens
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital (RPAH), Sydney, New South Wales, Australia
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia
- RPA Academic Institute of Surgery, Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Michael Solomon
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital (RPAH), Sydney, New South Wales, Australia
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia
- RPA Academic Institute of Surgery, Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Julia Dubowitz
- Department of Anaesthesia, Perioperative Medicine, and Pain Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- The Sir Peter MacCallum Department of Oncology, and The Department of Critical Care, The University of Melbourne, Melbourne, Victoria, Australia
| | - Walston Martis
- Department of Anaesthesia, Perioperative Medicine, and Pain Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- The Sir Peter MacCallum Department of Oncology, and The Department of Critical Care, The University of Melbourne, Melbourne, Victoria, Australia
| | - Hilmy Ismail
- Department of Anaesthesia, Perioperative Medicine, and Pain Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- The Sir Peter MacCallum Department of Oncology, and The Department of Critical Care, The University of Melbourne, Melbourne, Victoria, Australia
| | - Cherry Koh
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital (RPAH), Sydney, New South Wales, Australia
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia
- RPA Academic Institute of Surgery, Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Bernhard Riedel
- Department of Anaesthesia, Perioperative Medicine, and Pain Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- The Sir Peter MacCallum Department of Oncology, and The Department of Critical Care, The University of Melbourne, Melbourne, Victoria, Australia
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Couacault P, Avella D, Londoño‐Osorio S, Lorenzo AS, Gradillas A, Kärkkäinen O, Want E, Witting M. Targeted and untargeted metabolomics and lipidomics in dried blood microsampling: Recent applications and perspectives. ANALYTICAL SCIENCE ADVANCES 2024; 5:e2400002. [PMID: 38948320 PMCID: PMC11210747 DOI: 10.1002/ansa.202400002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 07/02/2024]
Abstract
Blood microsampling (BµS) offers an alternative to conventional methods that use plasma or serum for profiling human health, being minimally invasive and cost effective, especially beneficial for vulnerable populations. We present a non-systematic review that offers a synopsis of the analytical methods, applications and perspectives related to dry blood microsampling in targeted and untargeted metabolomics and lipidomics research in the years 2022 and 2023. BµS shows potential in neonatal and paediatric studies, therapeutic drug monitoring, metabolite screening, biomarker research, sports supervision, clinical disorders studies and forensic toxicology. Notably, dried blood spots and volumetric absorptive microsampling options have been more extensively studied than other volumetric technologies. Therefore, we suggest that a further investigation and application of the volumetric technologies will contribute to the use of BµS as an alternative to conventional methods. Conversely, we support the idea that harmonisation of the analytical methods when using BµS would have a positive impact on its implementation.
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Affiliation(s)
- Pauline Couacault
- Metabolomics and Proteomics CoreHelmholtz Zentrum MünchenNeuherbergGermany
| | - Dennisse Avella
- Afekta Technologies Ltd.KuopioFinland
- School of PharmacyFaculty of Health SciencesUniversity of Eastern FinlandKuopioFinland
| | - Sara Londoño‐Osorio
- Centro de Metabolómica y Bioanálisis (CEMBIO)Facultad de FarmaciaUniversidad San Pablo‐CEUCEU UniversitiesUrbanización MontepríncipeBoadilla del MonteMadridSpain
| | - Ana S. Lorenzo
- Department of MetabolismDigestion and ReproductionImperial College LondonLondonUK
| | - Ana Gradillas
- Centro de Metabolómica y Bioanálisis (CEMBIO)Facultad de FarmaciaUniversidad San Pablo‐CEUCEU UniversitiesUrbanización MontepríncipeBoadilla del MonteMadridSpain
| | - Olli Kärkkäinen
- Afekta Technologies Ltd.KuopioFinland
- School of PharmacyFaculty of Health SciencesUniversity of Eastern FinlandKuopioFinland
| | - Elizabeth Want
- Department of MetabolismDigestion and ReproductionImperial College LondonLondonUK
| | - Michael Witting
- Metabolomics and Proteomics CoreHelmholtz Zentrum MünchenNeuherbergGermany
- Chair of Analytical Food ChemistryTUM School of Life SciencesTechnical University of MunichFreising‐WeihenstephanGermany
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8
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Arcand MA, Poulin D, Testa EJ, Lemme NJ. Testosterone: A Review for Orthopaedic Surgeons. JBJS Rev 2024; 12:01874474-202406000-00005. [PMID: 38889232 DOI: 10.2106/jbjs.rvw.24.00061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
» Testosterone replacement treatment (TRT) and anabolic androgenic steroid (AAS) use is common and possibly increasing.» Diagnosing and treating hypogonadism in men is controversial.» Hypogonadism and the use of AASs seem to have a detrimental effect on the musculoskeletal system. The current literature on TRT and the musculoskeletal system shows an increased risk of tendon injury.» There may be a role for testosterone supplementation in the postoperative period.
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Affiliation(s)
- Michel A Arcand
- Department of Orthopedic Surgery, Brown University, Providence, Rhode Island
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9
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Lima PMA, Barros YC, Barros ABN, Farias LM. Assessment of Anabolic Androgenic Steroids Use Among Professional CrossFit ® Athletes: Motives, Perception, and Safety. Subst Use Misuse 2024; 59:1488-1494. [PMID: 38812099 DOI: 10.1080/10826084.2024.2359717] [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] [Indexed: 05/31/2024]
Abstract
BACKGROUND Anabolic androgenic steroids (AAS) are traditionally used for the treatment/control of various diseases; however, they are being used for non-therapeutic and indiscriminate purposes to enhance sports performance and physical appearance. This study aimed to assess the prevalence and associated factors of AAS use among professional CrossFit® competitors. METHODS We conducted an observational cross-sectional survey in which an anonymous questionnaire was applied to professional CrossFit® athletes. RESULTS The prevalence of AAS usage was 33.3%. Most users were male (74.2%), aged between 30 and 39 years (51.6%), with completed higher education (83.9%), and had been training for more than 5 years (77.4%); the primary motivation for AAS use was performance enhancement (77.4%). Individuals who were older (p < 0.05) and more experienced in competitions (p < 0.01) are more likely to use AAS. Testosterone was the most employed AAS (71.0%); CrossFit® athletes typically used an average of 2 different AAS. The majority of users had notably sought advice from a physician (74.2%), and AAS were acquired from either drugstores (80.6%) or through illicit channels (29.0%). Moreover, 61.3% of AAS users reported experiencing adverse effects. CONCLUSIONS Our results demonstrated a higher prevalence of AAS users among professional competitors in CrossFit® compared to the general population; older age and greater experience in official competitions were decisive factors for a greater inclination toward AAS use. A significant percentage of athletes seek drugs through illegal channels. Despite the majority of users experiencing adverse effects, athletes report satisfaction with use, believing that the benefits still outweigh the drawbacks.
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Affiliation(s)
- Paulo M A Lima
- Núcleo de Pesquisa da Faculdade de Medicina da, Universidade de Rio Verde (NUPMA-UniRV) Goiânia, Brazil
| | - Ycaro C Barros
- Núcleo de Pesquisa da Faculdade de Medicina da, Universidade de Rio Verde (NUPMA-UniRV) Goiânia, Brazil
| | - Ana B N Barros
- Núcleo de Pesquisa da Faculdade de Medicina da, Universidade de Rio Verde (NUPMA-UniRV) Goiânia, Brazil
| | - Letícia M Farias
- Núcleo de Pesquisa da Faculdade de Medicina da, Universidade de Rio Verde (NUPMA-UniRV) Goiânia, Brazil
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dos Santos JC, de Souza E, Meneses-Santos D, Carvalho CRDO, dos Santos JL, Aidar FJ, Marçal AC. The Use of Anabolic Steroids by Bodybuilders in the State of Sergipe, Brazil. Eur J Investig Health Psychol Educ 2024; 14:1451-1469. [PMID: 38785594 PMCID: PMC11120124 DOI: 10.3390/ejihpe14050096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 05/04/2024] [Accepted: 05/06/2024] [Indexed: 05/25/2024] Open
Abstract
Bodybuilding, as a high-performance sport, requires regular strength and resistance exercises with the principal objective of increasing muscle hypertrophy. However, many bodybuilders resort to the use of anabolic-androgenic steroids (AASs) to improve their performance in a short period of time. This study employs a survey-type, cross-sectional, descriptive-analytical method to evaluate the profile of bodybuilding athletes in the State of Sergipe, Brazil, and verify the level of knowledge/awareness about the health risks and impacts resulting from the use of such substances. Finite- and convenience-type populations are assessed, including individuals of both sexes, aged older than 18 years, self-declared bodybuilding athletes residing in the State of Sergipe, Brazil, and participating in regional and/or state competitions. As a result, no significant relationships were determined between sex (p = 0.492), age (p = 0.460), family income (p = 0.141), and medical follow-up sessions. For the variables level of education and medical follow-up vs. no follow-up sessions, a significant result was achieved (p = 0.01), with 74.3% of individuals reporting having follow-up treatment and 25.7% responding that they had no follow-up treatment, a percentage representing the group that completed their higher education. The substances most used by the athletes were Sustanon 250 or Durateston, Nandrolone Decanoate (Deca or Deca-Durabolin), and Testosterone. The most-reported acute side effects were acne at 33.8% (n = 20), irritability at 32.1% (n = 19), alopecia (hair loss), and nervousness at 23.7% (n = 14). The most-reported chronic side effects were arterial hypertension at 36.0% (n = 9), liver disease at 28.0% (n = 7), and cancer (non-specific) at 8.0% (n = 2). We concluded that, regardless of the athletes' socioeconomic profiles, the use of AASs was high, with two or more substances being used in combination and for a prolonged period. Thus, it is necessary to promote awareness campaigns regarding the use of AASs and their effects on high-performance and recreational athletes.
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Affiliation(s)
- Josué Cruz dos Santos
- Programa de Pós-Graduação em Educação Física, Universidade Federal de Sergipe, São Cristóvão 49100-000, Brazil; (J.C.d.S.); (E.d.S.); (J.L.d.S.)
| | - Erivaldo de Souza
- Programa de Pós-Graduação em Educação Física, Universidade Federal de Sergipe, São Cristóvão 49100-000, Brazil; (J.C.d.S.); (E.d.S.); (J.L.d.S.)
| | - Daniela Meneses-Santos
- Departamento de Morfologia, Universidade Federal de Sergipe, São Cristóvão 49100-000, Brazil;
| | | | - Jymmys Lopes dos Santos
- Programa de Pós-Graduação em Educação Física, Universidade Federal de Sergipe, São Cristóvão 49100-000, Brazil; (J.C.d.S.); (E.d.S.); (J.L.d.S.)
| | - Felipe J. Aidar
- Departamento de Educação Física, Universidade Federal de Sergipe, São Cristóvão 49100-000, Brazil;
| | - Anderson Carlos Marçal
- Departamento de Morfologia, Universidade Federal de Sergipe, São Cristóvão 49100-000, Brazil;
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11
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Baytugan NZ, Kandemir HÇ. The effect of anabolic androgenic steroids on heart rate recovery index and electrocardiographic parameters in male bodybuilders. J Electrocardiol 2024; 84:95-99. [PMID: 38579637 DOI: 10.1016/j.jelectrocard.2024.03.015] [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: 01/27/2024] [Revised: 03/21/2024] [Accepted: 03/25/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND The control of the cardiovascular system depends on the autonomic nerve system. Chronic anabolic andorogenic steroids (AAS) use causes sympathovagal imbalance and increases sympathetic nerve activity. OBJECTIVE The reduction in heart rate from the peak exercise rate following the end of the exercise stress test is known as the heart rate recovery index (HRRI). Several methods have been utilized to assess myocardial repolarization, such as QT interval (QT), corrected QT interval (QTc), and T-wave peak-to-end interval (Tp-e interval). Based on a growing number of data a higher Tp-e/QT ratio is linked to malignant ventricular arrhythmias, and an increased Tp-e interval may correlate with the transmural dispersion of repolarization. Our hypothesis is that the use of chronic AAS was decrease HRRI during maximal exercise and increased risk of cardiac arrhythmias and sudden cardiac death. METHODS This study included 44 male bodybuilders, with an average age of 29.7 ± 8.14 years, divided into AAS abuse [AAS users (n = 21) and AAS nonuser (n = 23)]. RESULTS The first (p = 0.001) and second minute (p = 0.001) HRRI of the subjects with AAS users were significantly lower than those of the control group. Additionally, HRRI after the third (p = 0.004) and fifth minutes (p = 0.007) of the recovery period were significantly lower in AAS group compared with the control group. Who used AAS had significantly higher QT, QTc, Tp-e, Tp-e/QT, and Tp-e/QTc values than non-users (all p = 0.001). CONCLUSIONS Chronic AAS use has been shown to cause sympathetic dominance, which may be a pro arrhythmic state.
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12
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Azevedo RA, Gualano B, Teixeira TA, Nascimento BCG, Hallak J. Abusive use of anabolic androgenic steroids, male sexual dysfunction and infertility: an updated review. FRONTIERS IN TOXICOLOGY 2024; 6:1379272. [PMID: 38711907 PMCID: PMC11070513 DOI: 10.3389/ftox.2024.1379272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 04/09/2024] [Indexed: 05/08/2024] Open
Abstract
The evolving prevalence of anabolic androgenic steroids (AAS) abuse among nonathletes is alarming because of the known harm to an individual's health. Among the adverse effects of AAS abuse, male infertility and sexual dysfunction have been often reported in the literature, but little is known regarding its actual prevalence, possible underpinning mechanisms, and potential treatments either during or post-AAS usage. Thus, the current narrative review summarizes the state-of-art regarding the effects of AAS on male fertility and sexual function. Evidence was gathered from the latest reviews and recent original studies, specifically from prospective cohorts and clinical trials, ultimately resulting in five main topics of discussion. First, AAS usage is briefly characterized by its historical background, main physiological mechanisms, and the most frequently used AAS substances. Second, data on the prevalence of AAS-induced male infertility and sexual dysfunction are described. Third, some new insights on possible underpinning mechanisms of AAS-induced male infertility and sexual dysfunction are thoroughly discussed, with particular attention to histological data derived from animal models and the latest insights from prospective cohorts in humans. Fourth, the potential treatments during and after the AAS usage are presented, highlighting the odds of resolving male infertility and sexual dysfunction. Fifth, future directions on this topic are discussed, focusing on the methodological robustness of scientific studies.
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Affiliation(s)
- Rafael de Almeida Azevedo
- Applied Physiology and Nutrition Research Group, Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Bruno Gualano
- Applied Physiology and Nutrition Research Group, Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Thiago Afonso Teixeira
- Division of Urology, Department of Surgery, University Hospital, School of Medicine and Drug Research Laboratory, Federal University of Amapa, Macapá, Brazil
- Men’s Health Study Group, Institute for Advanced Studies, University of Sao Paulo, São Paulo, Brazil
- Androscience Institute for Science, Education and Advanced Projects in Male Health, São Paulo, Brazil
| | | | - Jorge Hallak
- Men’s Health Study Group, Institute for Advanced Studies, University of Sao Paulo, São Paulo, Brazil
- Androscience Institute for Science, Education and Advanced Projects in Male Health, São Paulo, Brazil
- Division of Urology, Department of Surgery, University of Sao Paulo, São Paulo, Brazil
- Androscience—Science and Innovation Center and High Complexity Clinical and Research Andrology Laboratory, São Paulo, Brazil
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13
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Akula KP, McBeth LR, Hofer MD. The sexual impact of androgenic anabolic steroid abuse an understudied phenomena. Int J Impot Res 2024:10.1038/s41443-024-00879-6. [PMID: 38594389 DOI: 10.1038/s41443-024-00879-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 03/08/2024] [Accepted: 04/02/2024] [Indexed: 04/11/2024]
Affiliation(s)
- Kole P Akula
- University of Texas San Antonio Health Sciences Center, San Antonio, TX, USA.
| | - Lucien R McBeth
- San Antonio Uniformed Health Sciences Consortium, San Antonio, TX, USA
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Horn J. The dichotomy between health and drug abuse in bodybuilding. NORDIC STUDIES ON ALCOHOL AND DRUGS 2024; 41:212-225. [PMID: 38645972 PMCID: PMC11027851 DOI: 10.1177/14550725231206011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/21/2023] [Indexed: 04/23/2024] Open
Abstract
Aim: The aim of the present study was to investigate the expansion and prevalence of anabolic steroid use by examining the divergent effects between health and drug abuse and to create more awareness around the harmful consequences of these drugs when administered at abusive levels. Methods: A focused and concise literature search was conducted, and 101 high-quality articles were included in the review. Results: The findings underscore the adverse health risks of steroid abuse, emphasizing the stark contrast between health and drug abuse. Conclusions: While steroids and other performance-enhancing drugs can yield muscle growth, strength and even fat loss, abusing these substances can lead to adverse health outcomes. Furthermore, within the fitness subculture, particularly in the realm of bodybuilding, steroid abuse fosters an atmosphere of cheating and deception, frequently downplaying or ignoring the negative and sometimes deadly consequences it brings.
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15
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Karila D, Kerlan V, Christin-Maitre S. Androgenic steroid excess in women. ANNALES D'ENDOCRINOLOGIE 2024; 85:142-149. [PMID: 38040089 DOI: 10.1016/j.ando.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 11/20/2023] [Indexed: 12/03/2023]
Abstract
Excessive use of anabolic-androgenic steroids (AAS) in sport occurs among professional athletes but increasingly also in amateurs. Prevalence of steroid use has been on the rise for a number of years. While the practice involves mostly men, it also occurs in women with an estimated prevalence of 1.6%. Since 2014, a 'steroid passport' has operated for sports people in competition that is based on longitudinal urinary and blood steroid levels, measured by liquid chromatography and mass spectrometry. Androgen excess stimulates muscle growth and improves muscle performance. However, their consumption carries numerous side effects, including myocardial hypertrophy; altered lipid metabolism and pro-thrombotic effects. The excess of AAS is associated with increased risk of atherosclerosis and cardiovascular events. Data for their effects in women is lacking. Perturbations of the menstrual cycle are common in female athletes, with spaniomenorrhea and even amenorrhea. This can be a consequence of gonadotropin insufficiency due to negative caloric balance, but may also be due to endogenous or exogenous hyperandrogenism. The use of AAS is probably underestimated as a public health issue, particularly in women, and thus presents a prevention challenge for healthcare professionals.
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Affiliation(s)
- Daphné Karila
- Service d'endocrinologie, diabétologie et médecine de la reproduction, hôpital Saint-Antoine, Assistance publique-Hôpitaux de Paris, 75012 Paris, France; Sorbonne université, 75006 Paris, France.
| | - Véronique Kerlan
- Service d'endocrinologie, hôpital de Brest, université de Bretagne-Occidentale, 29200 Brest, France
| | - Sophie Christin-Maitre
- Service d'endocrinologie, diabétologie et médecine de la reproduction, hôpital Saint-Antoine, Assistance publique-Hôpitaux de Paris, 75012 Paris, France; Sorbonne université, 75006 Paris, France
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16
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Chu AT, Mehta A. The implications of supraphysiological testosterone supplementation. J Sex Med 2024; 21:273-274. [PMID: 38566537 DOI: 10.1093/jsxmed/qdad179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/03/2023] [Accepted: 12/10/2023] [Indexed: 04/04/2024]
Affiliation(s)
- Alice T Chu
- Department of Urology, Emory University School of Medicine, Atlanta, GA 30332, United States
| | - Akanksha Mehta
- Department of Urology, Emory University School of Medicine, Atlanta, GA 30332, United States
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17
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Karagun B. Carotid intima media thickness as a marker of increased cardiovascular risk due to androgenic anabolic steroids in male bodybuilders: a cross-sectional study. J Sports Med Phys Fitness 2024; 64:311-317. [PMID: 38213269 DOI: 10.23736/s0022-4707.23.15556-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
BACKGROUND The usage of androgenic-anabolic steroids (AAS) leads to severe side effects. The aim of our study was to investigate the effects of AAS on the increase in the carotid intima-media thickness which is regarded as predictor of cardiovascular disorders and determine the association of ASS usage to urinary, hepatic, and hematological systems as well as lipid disorders. METHODS A total of 60 male bodybuilders (30 AAS users with a mean age of 31.2±8.9 years and 30 AAS nonusers with a mean age of 31.2±8.9 years) were assessed in this cross-sectional study. The patients' demographic, radiologic, hormonal, and biochemical parameters were recorded. The carotid intima-media thickness (CIMT) was measured using B-mode ultrasound in both groups. Abdominal ultrasonography was used to assess for the presence of fatty liver. RESULTS CIMT was significantly increased in AAS (0.72±0.13 mm) users than in the controls (0.47±0.07 mm) (P<0.001). The mean duration of AAS usage was 2.70±2.13 years. There was a statistically significant positive correlation between the duration of AAS usage and CIMT (r=0.710; P<0.001). A statistically significant negative correlation among HDL, LH, and CIMT was found in the correlation analysis between biochemical parameters and CIMT among AAS users (respectively, r and P values were: r=0.399; P=0.029; r=-0.366; P=0.047; r=-0.287; P=0.035). Likewise, a negative correlation (r=-0.425; P=0.019) was found between FSH and CIMT. CONCLUSIONS We found that the usage of AAS among male bodybuilders has led to an increase in CIMT, which is associated with poor cardiovascular health. The results of our study highlight the vital importance of educating male bodybuilders who use these chemicals about the side effects.
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Affiliation(s)
- Baris Karagun
- Division of Endocrinology and Metabolism, Toros State Hospital, Mersin, Türkiye -
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18
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Barcelos MN, Gonçalves-Santos E, Souza MA, Santos EC, Gonçalves RV, Castro-Gamero AM, Novaes RD. Prolonged testosterone 17β-cyclopentylpropionate exposition induces behavioral, ovarian, oviductal, uterine and reproductive disturbances in female mice. Life Sci 2024; 338:122408. [PMID: 38181852 DOI: 10.1016/j.lfs.2023.122408] [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: 10/27/2023] [Revised: 12/16/2023] [Accepted: 12/29/2023] [Indexed: 01/07/2024]
Abstract
Anabolic-androgenic steroids (AAS) abuse is often associated with metabolic disorders and infertility. However, the current evidence on AAS-induced reproductive toxicity is mainly based on male studies. Thus, AAS repercussions on female reproductive capacity remain poorly understood, despite scarce evidence that fertility determinants may be more severely impaired in females than males exposed to these drugs. Accordingly, this study used an integrated framework to investigate the impact of different testosterone 17β-cyclopentylpropionate (TC) doses on pain sensitivity, aggressiveness, anxiety, sexual behavior, ovarian, oviductal, uterine and reproductive morphofunctional and molecular outcomes. These parameters were used to explore the reproductive capacity in female mice exposed to this synthetic testosterone ester. The animals were untreated or intraperitoneally treated with 5, 10 and 20 mg/kg TC every 48 h for 12 weeks. Our findings indicated that testosterone was upregulated while the hormones luteinizing, follicle-stimulating, estrogen and progesterone were down-regulated by TC. This AAS also exerted deleterious effects on anxiety, aggressivity, nociception, exploratory and sexual behavior in female mice. Concurrently, TC attenuated ovarian follicle maturation, interrupted the estrous cycle, induced oviductal and uterine hypotrophy. Estrous cyclicity was reestablished 60 days after AAS treatment. However, TC-treated mice still exhibited impaired reproductive capacity, a disturbance potentially related to deficiency in folliculogenesis, sex hormones production, and endometrial receptivity mediate by ER-α, PR, HOXA-10 and LIF down-regulation. Taken together, our findings indicated that in addition to female behavior, reproductive organs microstructure and function are markedly impaired by TC in a dose-dependent manner, whose time-dependent reversibility remains to be clarified.
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Affiliation(s)
- Mônica N Barcelos
- Programa de Pós-Graduação em Biociências Aplicadas à Saúde, Universidade Federal de Alfenas, Alfenas 37130-001, Minas Gerais, Brazil
| | - Elda Gonçalves-Santos
- Programa de Pós-Graduação em Biociências Aplicadas à Saúde, Universidade Federal de Alfenas, Alfenas 37130-001, Minas Gerais, Brazil
| | - Matheus A Souza
- Programa de Pós-Graduação em Ciências Biológicas, Universidade Federal de Alfenas, Alfenas 37130-001, Minas Gerais, Brazil
| | - Eliziária C Santos
- Faculdade de Medicina, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina 39100-000, Minas Gerais, Brazil
| | - Reggiani V Gonçalves
- Programa de Pós-Graduação em Biologia Animal, Departamento de Biologia Animal, Universidade Federal de Viçosa, Viçosa 36570-900, Minas Gerais, Brazil
| | - Angel Mauricio Castro-Gamero
- Programa de Pós-Graduação em Biociências Aplicadas à Saúde, Universidade Federal de Alfenas, Alfenas 37130-001, Minas Gerais, Brazil; Instituto de Ciências da Natureza, Universidade Federal de Alfenas, Alfenas 37130-001, Minas Gerais, Brazil
| | - Rômulo D Novaes
- Programa de Pós-Graduação em Biociências Aplicadas à Saúde, Universidade Federal de Alfenas, Alfenas 37130-001, Minas Gerais, Brazil; Programa de Pós-Graduação em Ciências Biológicas, Universidade Federal de Alfenas, Alfenas 37130-001, Minas Gerais, Brazil; Programa de Pós-Graduação em Biologia Animal, Departamento de Biologia Animal, Universidade Federal de Viçosa, Viçosa 36570-900, Minas Gerais, Brazil; Instituto de Ciências Biomédicas, Universidade Federal de Alfenas, Alfenas 37130-001, Minas Gerais, Brazil.
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Cava E, Padua E, Campaci D, Bernardi M, Muthanna FMS, Caprio M, Lombardo M. Investigating the Health Implications of Whey Protein Consumption: A Narrative Review of Risks, Adverse Effects, and Associated Health Issues. Healthcare (Basel) 2024; 12:246. [PMID: 38255133 PMCID: PMC10815430 DOI: 10.3390/healthcare12020246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 01/10/2024] [Accepted: 01/17/2024] [Indexed: 01/24/2024] Open
Abstract
This narrative review critically examines the current research on the health implications of whey protein (WP) supplementation, with a focus on potential risks and adverse effects. WP, commonly consumed for muscle building and weight loss, has been associated with various health concerns. Our comprehensive analysis involved a thorough search of multiple databases, resulting in the inclusion of 21 preclinical and human studies that collectively offer a detailed overview of WP's health impacts. The review reveals significant findings, such as WP's potential link to liver and kidney damage, alterations in gut microbiota, increased acne incidence, impacts on bone mass, and emotional and behavioural changes. These findings underscore the complexity of WP's effects on human health, indicating both beneficial and detrimental outcomes in relation to different posologies in a variety of settings. Our study suggests caution for the protein intake in situations of hepatic and renal compromised functions, as well as in acne susceptibility, while possible beneficial effects can be achieved for the intestinal microbiota, humoral and behavioural level, and finally bone and muscle mass in elderly. We emphasizes the importance of balanced WP consumption and call for more in-depth research to understand its long-term health effects. Health professionals and individuals considering WP supplementation should be aware of these potential risks and approach its use with informed caution.
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Affiliation(s)
- Edda Cava
- Clinical Nutrition and Dietetics, San Camillo Forlanini Hospital, Rome, cir.ne Gianicolense 87, 00152 Rome, Italy;
| | - Elvira Padua
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Open University, Via di Val Cannuta, 247, 00166 Rome, Italy; (E.P.); (D.C.); (M.B.); (M.C.)
| | - Diego Campaci
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Open University, Via di Val Cannuta, 247, 00166 Rome, Italy; (E.P.); (D.C.); (M.B.); (M.C.)
| | - Marco Bernardi
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Open University, Via di Val Cannuta, 247, 00166 Rome, Italy; (E.P.); (D.C.); (M.B.); (M.C.)
| | - Fares M. S. Muthanna
- Pharmacy Department, Faculty of Medicine and Health Sciences, University of Science and Technology-Aden, Alshaab Street, Enmaa City 22003, Yemen;
| | - Massimiliano Caprio
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Open University, Via di Val Cannuta, 247, 00166 Rome, Italy; (E.P.); (D.C.); (M.B.); (M.C.)
- Laboratory of Cardiovascular Endocrinology, San Raffaele Research Institute, IRCCS San Raffaele Roma, Via di Val Cannuta, 247, 00166 Rome, Italy
| | - Mauro Lombardo
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Open University, Via di Val Cannuta, 247, 00166 Rome, Italy; (E.P.); (D.C.); (M.B.); (M.C.)
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Henriksen HCB, Havnes IA, Jørstad ML, Abdullah R, Thorsby PM, Hauger LE, Edvardsen T, Haugaa KH, Almaas VM, Bjørnebekk A. Treatment-seeking behavior and cardiovascular morbidity among men with anabolic-androgenic steroid use: A cross-sectional study. Scand J Med Sci Sports 2024; 34:e14554. [PMID: 38268076 DOI: 10.1111/sms.14554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/14/2023] [Accepted: 12/15/2023] [Indexed: 01/26/2024]
Abstract
AIMS To determine associations between anabolic-androgenic steroid (AAS) use-related morbidity including cardiovascular disease (CVD) and engagement to health services. METHODS In this cross-sectional study, 90 males with at least 12 months cumulative current or former use of AAS were included. The participants were divided into a treatment-seeking group (TSG) and a non-treatment seeking group (non-TSG) based on their responses to a self-report web questionnaire. All participants were screened for symptoms that could be indicative of CVD through a clinical interview, and examined with blood samples, blood pressure measurements and transthoracic echocardiography. RESULTS In the total sample (n = 90), mean age was 39 ± 11 years with cumulative AAS use of 12 ± 9 years. Among men in the TSG with current use there were higher prevalence of dyspnoea (50% vs 7%) and reduced left ventricular ejection fraction (LVEF) in conjunction with left ventricular hypertrophy (LVH) (36 vs. 9%) and/or high blood pressure (55% vs. 19%) compared to men in the non-TSG. Among men with current AAS use and established LVEF <50% (n = 25) or LVH (n = 21), 44% (11) and 43% (9) respectively, had never engaged health services due to AAS-related adverse effects. Deviant liver- and kidney parameters were frequently observed in the total sample but without between-group differences. CONCLUSIONS Treatment-seeking behavior among current AAS users may be associated with increased levels of dyspnoea and established CVD. Despite objective signs of severe CVD among a substantial amount of study participants, it is of great concern that the majority had never sought treatment for AAS-related concerns.
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Affiliation(s)
- Hans Christian Bordado Henriksen
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Amalia Havnes
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Marie Lindvik Jørstad
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- National Advisory Unit on Substance Use Treatment, 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
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- ProCardio Center for Research Based Innovation, Department of Cardiology, Rikshospitalet, Oslo University Hospital, 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, Oslo, Norway
| | - Lisa Evju 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, Oslo, Norway
| | - Thor Edvardsen
- ProCardio Center for Research Based Innovation, Department of Cardiology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
| | - Kristina H Haugaa
- ProCardio Center for Research Based Innovation, Department of Cardiology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
| | - Vibeke Marie Almaas
- ProCardio Center for Research Based Innovation, Department of Cardiology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
| | - Astrid Bjørnebekk
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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21
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Derwand D, Zierau O, Thieme D, Keiler AM. Up to the maximum-testosterone dose-dependent effects on anabolic and androgen responsive tissues in orchiectomized rats. Andrology 2024; 12:231-240. [PMID: 37254653 DOI: 10.1111/andr.13466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 05/15/2023] [Accepted: 05/24/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND Despite the high number of synthetic androgenic-anabolic steroids, testosterone is still misused for doping in amateur and professional sports. However, only few studies investigated the dose-response effects of testosterone beyond its physiological concentrations and in over 90 years of research, no saturation dosage has been experimentally described for exogenous testosterone administration. OBJECTIVES We want to elucidate the physiological and pathophysiological effects of supra-physiological testosterone application and close this gap in testosterone dose-response data. MATERIALS AND METHODS Male orchiectomized rats were treated with different testosterone doses ranging from 0.1 to 50 mg/kg body weight for 3 weeks. Several physiological endpoints (e.g., body weight, organ and muscle weight, muscle strength, muscle fiber size) were examined during and after the termination of the treatment with an adjusted Hershberger assay, open-field-test, and (immuno-)histologic. RESULTS The wet weights of androgen responsive organs (penis, prostate, seminal vesicle) showed a significant increase in a dose-dependent manner. Histological evaluation of the prostate showed a significant higher percentage of KI67 positive prostate nuclei in the highest dosage group and an increasing hyperplasia with increasing testosterone administered. A significant anabolic effect was only observed in Levator ani wet weight, and to minor degree for the cardiac muscle. Regarding other skeletal muscles (Musculus soleus and Musculus gastrognemicus), no significant testosterone effects were observed. We showed a significant increasing dosage-response effect for testosterone in androgen responsive organs with saturation at the two highest concentration of 10 and 50 mg/kg body weight. DISCUSSION AND CONCLUSION The dose-dependent androgenic effects of testosterone were well observable and the anabolic effects on muscle tissue were visible although to a lesser degree, without the support of aerobic exercise and a protein rich diet. Future studies should investigate a combinatorial effect of testosterone and training. Nevertheless, with the chosen range of applied testosterone, we showed a saturation of testosterone effects in prostate, seminal vesicle, penis, and Levator ani.
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Affiliation(s)
- Daniel Derwand
- Institute of Doping Analysis and Sports Biochemistry Dresden, Kreischa, Germany
- Faculty of Biology, Technische Universität Dresden, Dresden, Germany
| | - Oliver Zierau
- Faculty of Biology, Technische Universität Dresden, Dresden, Germany
| | - Detlef Thieme
- Institute of Doping Analysis and Sports Biochemistry Dresden, Kreischa, Germany
| | - Annekathrin Martina Keiler
- Institute of Doping Analysis and Sports Biochemistry Dresden, Kreischa, Germany
- Faculty of Biology, Technische Universität Dresden, Dresden, Germany
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22
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Thevis M, Kuuranne T, Geyer H. Annual banned-substance review 16 th edition-Analytical approaches in human sports drug testing 2022/2023. Drug Test Anal 2024; 16:5-29. [PMID: 37985429 DOI: 10.1002/dta.3602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 10/24/2023] [Indexed: 11/22/2023]
Abstract
In this 16th edition of the annual banned-substance review on analytical approaches in human sports drug testing, literature on recent developments in this particular section of global anti-doping efforts that was published between October 2022 and September 2023 is summarized and discussed. Most recent additions to the continuously growing portfolio of doping control analytical approaches and investigations into analytical challenges in the context of adverse analytical findings are presented, taking into account existing as well as emerging challenges in anti-doping, with specific focus on substances and methods of doping recognized in the World Anti-Doping Agency's 2023 Prohibited List. As in previous years, focus is put particularly on new or enhanced analytical options in human doping controls, appreciating the exigence and core mission of anti-doping and, equally, the conflict arising from the opposingly trending extent of the athlete's exposome and the sensitivity of instruments nowadays commonly available in anti-doping laboratories.
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Affiliation(s)
- Mario Thevis
- Center for Preventive Doping Research - Institute of Biochemistry, German Sport University Cologne, Cologne, Germany
- European Monitoring Center for Emerging Doping Agents, Cologne, Germany
| | - Tiia Kuuranne
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Genève and Lausanne, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Epalinges, Switzerland
| | - Hans Geyer
- Center for Preventive Doping Research - Institute of Biochemistry, German Sport University Cologne, Cologne, Germany
- European Monitoring Center for Emerging Doping Agents, Cologne, Germany
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23
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Deniz MA, Matsar Öz R. Gynecomastia on Thoracic Computed Tomography. Cureus 2024; 16:e51509. [PMID: 38304650 PMCID: PMC10832307 DOI: 10.7759/cureus.51509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2024] [Indexed: 02/03/2024] Open
Abstract
Background and objective Gynecomastia is a benign proliferation of ductal epithelium in the retroareolar region in male patients. The aim of this study was to investigate the frequency of gynecomastia in male patients who underwent thoracic computed tomography (CT) imaging at our clinic, assess possible causes, highlight the imaging characteristics of gynecomastia, and compare our findings with the literature. Materials and methods Male patients over 18 years of age who underwent thoracic CT imaging in our clinic were included in the study. Patients were initially assessed based on age and the presence of gynecomastia. The patients with gynecomastia were evaluated in terms of age, gynecomastia localization (right, left, and bilateral), gynecomastia type (nodular, dentritic, and diffuse), and possible etiology. Results The study included 1500 patients with a mean age of 45.6±21.7 years, and 470 (31.3%) patients had gynecomastia. Gynecomastia was on the right side in 11.3%, on the left side in 11.1%, and bilateral in 77.7% of the patients. Gynecomastia was nodular in 52.1%, dendritic in 35.3%, and diffuse in 17.2% of the patients. The causative factor could not be identified in 44.3% of the patients with gynecomastia. Among cases where the etiology was identified (56.7%), the most common factors were cancer (23.4%), chronic kidney disease (CKD) (13.2%), and chronic hepatitis B (10.7%). Conclusion When evaluating thoracic CT, the breast area, in addition to the lungs, chest wall, and bone structures, should also be evaluated carefully. With the increased use of thoracic CT scans, incidentally detected gynecomastia in patients is also on the rise. Knowing the presence of gynecomastia is very important for the clinician to determine the etiology and treat the underlying disease. Therefore, detecting and reporting gynecomastia on thoracic CT can prevent unnecessary advanced breast imaging methods and play a very important role in treating the underlying etiology.
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Affiliation(s)
| | - Rukan Matsar Öz
- Radiology, Diyarbakır Pediatric Disease Hospital, Diyarbakır, TUR
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24
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de Almeida FN, da Cunha Nascimento D, Moura RF, Peixoto DL, de Moraes WMAM, Schoenfeld BJ, Neto IVDS, Prestes J. Training, Pharmacological Ergogenic Aids, Dehydration, and Nutrition Strategies during a Peak Week in Competitive Brazilian Bodybuilders: An Observational Cross-Sectional Study in a Non-World Anti-Doping Agency Competitive Environment. Sports (Basel) 2023; 12:11. [PMID: 38251285 PMCID: PMC10819153 DOI: 10.3390/sports12010011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/16/2023] [Accepted: 12/26/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND this observational and cross-sectional study aimed to describe training, pharmacological ergogenic aids, dehydration, and nutrition strategies during a peak week in competitive bodybuilders and monitor changes that occurred across this period. METHODS Ten amateur bodybuilders were followed during a peak week phase and one day post-contest. Training, diet, dehydration protocol, anabolic steroid use, and nonsteroidal agents were recorded, prescribed, and supervised by the same coach in charge. Body composition, resting metabolic rate, and circumferences were assessed by the research team. RESULTS Overall, during the peak week phase, the use of anabolic steroids, diuretics, and other pharmacological aids was high among athletes, and the dose and frequency were similar between competitors. Despite the use of supraphysiological doses of drugs, bodybuilders displayed a statistical reduction of lean mass markers, resting metabolic rate, and fat mass markers, possibly influenced by the performance of high volumes of aerobic exercise combined with dietary energy restriction. CONCLUSIONS The main findings of this study display that the coach in charge of Brazilian bodybuilders applied the same anabolic steroid, diuretic, and other pharmacological protocols for all competitors. Moreover, the protocols employed by bodybuilders did not fully attenuate the loss of lean mass during the peak week period.
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Affiliation(s)
- Fernando Noronha de Almeida
- Post graduation Program on Physical Education, Catholic University of Brasilia (UCB), Brasília 71966900, Brazil; (F.N.d.A.); (D.d.C.N.); (R.F.M.); (D.L.P.); (W.M.A.M.d.M.)
| | - Dahan da Cunha Nascimento
- Post graduation Program on Physical Education, Catholic University of Brasilia (UCB), Brasília 71966900, Brazil; (F.N.d.A.); (D.d.C.N.); (R.F.M.); (D.L.P.); (W.M.A.M.d.M.)
| | - Ronaldo Ferreira Moura
- Post graduation Program on Physical Education, Catholic University of Brasilia (UCB), Brasília 71966900, Brazil; (F.N.d.A.); (D.d.C.N.); (R.F.M.); (D.L.P.); (W.M.A.M.d.M.)
| | - Douglas Leão Peixoto
- Post graduation Program on Physical Education, Catholic University of Brasilia (UCB), Brasília 71966900, Brazil; (F.N.d.A.); (D.d.C.N.); (R.F.M.); (D.L.P.); (W.M.A.M.d.M.)
| | - Wilson Max Almeida Monteiro de Moraes
- Post graduation Program on Physical Education, Catholic University of Brasilia (UCB), Brasília 71966900, Brazil; (F.N.d.A.); (D.d.C.N.); (R.F.M.); (D.L.P.); (W.M.A.M.d.M.)
| | - Brad J. Schoenfeld
- Department of Exercise Science and Recreation, City University of New York, Herbert H. Lehman College, New York, NY 10468, USA;
| | - Ivo Vieira de Sousa Neto
- School of Physical Education and Sport of Ribeirão Preto, University of São Paulo (USP), São Paulo 14040900, Brazil;
| | - Jonato Prestes
- Post graduation Program on Physical Education, Catholic University of Brasilia (UCB), Brasília 71966900, Brazil; (F.N.d.A.); (D.d.C.N.); (R.F.M.); (D.L.P.); (W.M.A.M.d.M.)
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25
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Wenbo Z, Yan Z. The Uses of Anabolic Androgenic Steroids Among Athletes; Its Positive and Negative Aspects- A Literature Review. J Multidiscip Healthc 2023; 16:4293-4305. [PMID: 38170017 PMCID: PMC10759908 DOI: 10.2147/jmdh.s439384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024] Open
Abstract
The use of anabolic androgenic steroids (AAS) for strength training and muscle building is a widespread practice among athletes and young individuals. Athletes and bodybuilders are using these substances for various purposes, such as enhancing muscle mass, strengthening their bodies, and enhancing their performances. AAS exert a wide range of physiological effects that result in the activation of central signaling, resulting in adverse effects. Moreover, excessive use of AAS which can be categorized as AAS abuse; is linked to biological and psychological pathologies, which can lead to mortality. Complications arising from steroid abuse involve both cellular and physiological complications. Cellular complications arise when activation of signaling proteins like mTOR, Akt, etc. leads to alteration in protein synthesis pathways, cell cycle, oxidative stress, and apoptosis, contributing to damage at the cellular level. Physiological complications are evident with cardiovascular pathologies, including an altered lipid profile, cardiac hypertrophy, hypogonadism after discontinuation of AAS, and modulation of GABA receptors in the brain, all contributed by the androgen receptor signaling. Clinical complications budding from these altered physiological processes lead to clinical effects like testicular dysfunction, acne, gynecomastia, and neuropsychiatric disorders. Despite potential therapeutic benefits, AAS use is prohibited by the World Anti-Doping Agency (WADA) due to concerns over adverse health effects. This review highlights the molecular mechanisms, physiological processes, and clinical complications arising from the excessive use of AAS among athletes.
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Affiliation(s)
- Zhang Wenbo
- Department of Physical Education, Changchun Institute of Education, Changchun, Jilin, 130033, People’s Republic of China
| | - Zhang Yan
- School of Physical Education, Inner Mongolia Minzu University, Tongliao, Neimeng, 028000, People’s Republic of China
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26
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Skauen JE, Pallesen S, Bjørnebekk A, Chegeni R, Syvertsen A, Petróczi A, Sagoe D. Prevalence and correlates of androgen dependence: a meta-analysis, meta-regression analysis and qualitative synthesis. Curr Opin Endocrinol Diabetes Obes 2023; 30:309-323. [PMID: 37410490 DOI: 10.1097/med.0000000000000822] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
PURPOSE OF REVIEW To investigate the prevalence and correlates of androgen dependence among users. A meta-analysis, meta-regression analysis, and qualitative synthesis were conducted based on a systematic literature search in Google Scholar, ISO Web of Science, PsycNET, and PubMed. RECENT FINDINGS Twenty-six studies were included in the review and 18 studies ( N = 1782) in the statistical analysis. The overall lifetime androgen dependence prevalence was 34.4% [95% confidence interval (CI): 27.8-41.7, Q = 113.1, I2 = 85.0, P < 0.001]. Although males (36.1%, P < 0.001) and females (37.0%, P = 0.188) did not differ ( Q = 0.0, P = 0.930) in dependence prevalence, controlling for other study characteristics, higher study male sample proportion was related to higher dependence prevalence. Combined interview and questionnaire assessments showed higher prevalence compared to interviews only. Publications from 1990-1999 generated higher prevalence compared to 2000-2009 and 2010-2023 publications. Dependents were associated with a wide array of demographic inequalities, and biophysical, cognitive, emotional, and psychosocial problems. SUMMARY One of three persons who initiate androgen use experiences dependence along with various serious disorders. Androgen use and dependence should be considered an important public health issue requiring targeted health interventions.
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Affiliation(s)
- Jenny Eriksrød Skauen
- Department of Psychosocial Science
- Human Enhancement and Body Image Lab (HEBI Lab), Addiction Research Group, University of Bergen, Bergen
| | - Ståle Pallesen
- Department of Psychosocial Science
- Human Enhancement and Body Image Lab (HEBI Lab), Addiction Research Group, University of Bergen, Bergen
| | - Astrid Bjørnebekk
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital
| | - Razieh Chegeni
- Human Enhancement and Body Image Lab (HEBI Lab), Addiction Research Group, University of Bergen, Bergen
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - André Syvertsen
- Department of Psychosocial Science
- Human Enhancement and Body Image Lab (HEBI Lab), Addiction Research Group, University of Bergen, Bergen
| | - Andrea Petróczi
- School of Life Sciences, Pharmacy and Chemistry, Faculty of Health, Science, Social Care and Education, Kingston University, London, UK
- Institute of Health Promotion and Sport Sciences, Eötvös Loránd University (ELTE), Budapest, Hungary
| | - Dominic Sagoe
- Department of Psychosocial Science
- Human Enhancement and Body Image Lab (HEBI Lab), Addiction Research Group, University of Bergen, Bergen
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27
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Nguyen Hoai B, Hoang L, Nguyen Cao T, Pham Minh Q, A Jannini E. Testosterone and aging male, a perspective from a developing country. Aging Male 2023; 26:2223712. [PMID: 37335039 DOI: 10.1080/13685538.2023.2223712] [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: 04/16/2023] [Revised: 05/19/2023] [Accepted: 06/06/2023] [Indexed: 06/21/2023] Open
Abstract
PURPOSE Hypogonadism is associated with a wide range of physical and psychological symptoms that can affect the overall health of men. However, in a developing country, there are several imposing challenges in the diagnosis and treatment of hypogonadism, including a lack of awareness and understanding of the condition among healthcare providers and patients, limited resources and the high cost of treatment. This review aimed to examine the potential benefits and risks of testosterone replacement therapy (TRT) and provides a perspective of a developing country on the topic. MATERIALS AND METHODS A comprehensive literature review was conducted to gather relevant information on the impact of testosterone deficiency on ageing males and the effectiveness of TRT for treating hypogonadism. Published peer-reviewed articles were analyzed to evaluate the benefits and risks of TRT. Additionally, the unique challenges faced in the diagnosis and treatment of hypogonadism in a developing country were considered. RESULTS Testosterone replacement therapy has been shown to be an effective treatment for hypogonadism, particularly in symptomatic men with low testosterone levels. It offers potential benefits such as improvements in symptoms and overall quality of life. However, there are associated risks and side effects that need to be considered. In a developing country, challenges such as limited awareness and understanding of hypogonadism, resource constraints, and high treatment costs pose additional barriers to accessing TRT and comprehensive care. CONCLUSION In conclusion, TRT holds promise as a treatment for hypogonadism, but its implementation and accessibility face significant challenges in a developing country. Addressing these challenges, including raising awareness, allocating resources, and finding cost-effective solutions, is crucial for ensuring that men with hypogonadism in such settings receive appropriate diagnosis and treatment. Further research and efforts are needed to improve the management of hypogonadism in developing countries and optimize the potential benefits of TRT for affected individuals.
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Affiliation(s)
- Bac Nguyen Hoai
- Department of Andrology and Sexual Medicine, Hanoi Medical University's Hospital, Hanoi, Vietnam
| | - Long Hoang
- Department of Urology, Hanoi Medical University's Hospital, Hanoi, Vietnam
| | - Thang Nguyen Cao
- Department of Andrology and Sexual Medicine, Hanoi Medical University's Hospital, Hanoi, Vietnam
| | - Quan Pham Minh
- Department of Andrology and Sexual Medicine, Hanoi Medical University's Hospital, Hanoi, Vietnam
| | - Emmanuele A Jannini
- Chair of Endocrinology and Sexual Medicine (ENDOSEX), University of Rome Tor Vergata, Rome, Italy
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Rivero-Pino F, Casanova AG. Hepatotoxicity due to dietary supplements: state-of-the-art, gaps and perspectives. Crit Rev Toxicol 2023; 53:601-610. [PMID: 38062980 DOI: 10.1080/10408444.2023.2282415] [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: 08/03/2023] [Accepted: 10/23/2023] [Indexed: 12/22/2023]
Abstract
Food supplements are products intended to complement the normal diet and consist of concentrated sources of nutrients or other substances with a nutritional or physiological effect. Although they are generally considered safe if the manufacturer's recommendations are followed, many of them have shown hepatotoxic properties. This can cause many diseases (e.g. steatohepatitis and cirrhosis) characterized by progressive damage and malfunction of the liver that in the long term can lead to death. A review of the literature was carried out to elucidate which dietary supplements have been associated with cases of hepatotoxicity in recent years, with emphasis on those relevant to the consumer and the new trends (e.g. cannabidiol). It has been reported that the supplements described as hepatotoxic are mainly of botanical origin (e.g. green tea or turmeric) and those used in sports (mainly anabolic androgenic steroids). There is a great variability of compounds described as causing liver damage, although sometimes it is not possible to identify them, because they are contaminants or adulterants of the products. In addition, the prevalence of toxic effects after the administration of supplements is difficult to define due to underreporting and the lack of specific studies. Globally regarding hepatotoxicity of dietary supplements, there is a paucity of well-conducted clinical trials on the efficacy of these compounds and the frequency of related liver damage, as the use of these products is largely uncontrolled.
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Affiliation(s)
- Fernando Rivero-Pino
- Department of Medical Biochemistry, Molecular Biology, and Immunology, School of Medicine, University of Seville, Seville, Spain
| | - Alfredo G Casanova
- Toxicology Unit, Universidad de Salamanca, Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Group of Translational Research on Renal and Cardiovascular Diseases (TRECARD), Salamanca, Spain
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29
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Tibúrcio FC, Leite APS, Muller KS, Pinto CG, Valentino E, Castro PATDS, Matsumura CY, de Carvalho SF, Matheus SMM. Effects of Nandrolone Decanoate on Skeletal Muscle and Neuromuscular Junction of Sedentary and Exercised Rats. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1940. [PMID: 38003989 PMCID: PMC10673219 DOI: 10.3390/medicina59111940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/03/2023] [Accepted: 10/23/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: Nandrolone decanoate (ND) is the most widely used among the anabolic androgenic steroids (AAS), synthetic substances derived from testosterone, to improve muscular and health gains associated with exercises. The AAS leads to physical performance enhancement and presents anti-aging properties, but its abuse is associated with several adverse effects. Supraphysiological doses of AAS with or without physical exercise can cause morphological and functional alterations in neuromuscular interactions. This study aims to investigate the effects of ND supraphysiological doses in neuromuscular interactions, focusing on the soleus muscle and its neuromuscular junctions (NMJs) in rats, associated or not with physical exercise. Materials and Methods: Forty male Sprague Dawley rats were divided into four groups: sedentary and exercised groups, with or without ND at the dose of 10 mg/kg/week. The animals were treated for eight weeks, with intramuscular injections, and the soleus muscle was collected for morphological analyses. Results: The supraphysiological doses of ND in the sedentary group caused muscle degeneration, evidenced by splitting fibers, clusters of small fibers, irregular myofibrils, altered sarcomeres, an increase in collagen deposition and in the number of type I muscle fibers (slow-twitch) and central nuclei, as well as a decrease in fibers with peripheral nuclei. On the other hand, in the ND exercise group, there was an increase in the NMJs diameter with scattering of its acetylcholine receptors, although no major morphological changes were found in the skeletal muscle. Thus, the alterations caused by ND in sedentary rats were partially reversed by physical exercise. Conclusions: The supraphysiological ND exposure in the sedentary rats promoted an increase in muscle oxidative pattern and adverse morphological alterations in skeletal muscle, resulting from damage or post-injury regeneration. In the ND-exercised rats, no major morphological changes were found. Thus, the physical exercise partially reversed the alterations caused by ND in sedentary rats.
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Affiliation(s)
- Felipe Cantore Tibúrcio
- Medical School, São Paulo State University (Unesp), Botucatu 18618-687, SP, Brazil; (F.C.T.); (A.P.S.L.); (K.S.M.); (C.G.P.)
- Division of Anatomy, Department of Structural and Functional Biology, Institute of Biosciences, São Paulo State University (Unesp), Botucatu 18618-689, SP, Brazil; (C.Y.M.)
| | - Ana Paula Silveira Leite
- Medical School, São Paulo State University (Unesp), Botucatu 18618-687, SP, Brazil; (F.C.T.); (A.P.S.L.); (K.S.M.); (C.G.P.)
- Division of Anatomy, Department of Structural and Functional Biology, Institute of Biosciences, São Paulo State University (Unesp), Botucatu 18618-689, SP, Brazil; (C.Y.M.)
| | - Kevin Silva Muller
- Medical School, São Paulo State University (Unesp), Botucatu 18618-687, SP, Brazil; (F.C.T.); (A.P.S.L.); (K.S.M.); (C.G.P.)
- Division of Anatomy, Department of Structural and Functional Biology, Institute of Biosciences, São Paulo State University (Unesp), Botucatu 18618-689, SP, Brazil; (C.Y.M.)
| | - Carina Guidi Pinto
- Medical School, São Paulo State University (Unesp), Botucatu 18618-687, SP, Brazil; (F.C.T.); (A.P.S.L.); (K.S.M.); (C.G.P.)
- Division of Anatomy, Department of Structural and Functional Biology, Institute of Biosciences, São Paulo State University (Unesp), Botucatu 18618-689, SP, Brazil; (C.Y.M.)
| | - Erick Valentino
- Division of Anatomy, Department of Structural and Functional Biology, Institute of Biosciences, São Paulo State University (Unesp), Botucatu 18618-689, SP, Brazil; (C.Y.M.)
| | - Paula Aiello Tomé de Souza Castro
- Department of Physical Therapy, Center for Biological and Health Sciences, Federal University of São Carlos (UFSCar), São Carlos 13565-905, SP, Brazil;
| | - Cintia Yuri Matsumura
- Division of Anatomy, Department of Structural and Functional Biology, Institute of Biosciences, São Paulo State University (Unesp), Botucatu 18618-689, SP, Brazil; (C.Y.M.)
| | - Shelly Favorito de Carvalho
- Electron Microscopy Center, Institute of Biosciences, São Paulo State University (Unesp), Botucatu 18618-689, SP, Brazil;
| | - Selma Maria Michelin Matheus
- Division of Anatomy, Department of Structural and Functional Biology, Institute of Biosciences, São Paulo State University (Unesp), Botucatu 18618-689, SP, Brazil; (C.Y.M.)
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30
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Mulawkar PM, Maheshwari PN, Gauhar V, Agrawal SG, Mohammed TO, Singh AG, Tak GR, Shah US, Shukla DP, Mamankar D. Use of Anabolic-Androgenic Steroids and Male Fertility: A Systematic Review and Meta-analysis. J Hum Reprod Sci 2023; 16:268-285. [PMID: 38322636 PMCID: PMC10841926 DOI: 10.4103/jhrs.jhrs_90_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 11/22/2023] [Accepted: 11/22/2023] [Indexed: 02/08/2024] Open
Abstract
Background Anabolic-androgenic steroids (AASs) are often used by men for bodybuilding and to improve sports performance. The use is not limited to professional competitive athletes, but many amateur men. Objective The objective of this study was to assess and systematically review the effects of AAS on male fertility parameters, spermiogram, testosterone, follicle-stimulating hormone (FSH) and luteinising hormone (LH) and to review reversibility and other morbidity impacting fertility. Methods Eligibility criteria - We included studies mentioning data about adult males using supraphysiologic doses of AAS for sports performance or appearance enhancement, with comparison data from general population or matched controls if available reporting fertility parameters and sexual performance. Information sources - A systematic literature search was performed using PubMed, MEDLINE, EMBASE, Google Scholar and World of Science. Controlled clinical trials randomised or nonrandomised (if available), case series with or without matched controls, case reports, cross-sectional surveys, reports on follow-up of subjects caught in doping test and their fertility parameters when reported. Risk of bias/quality assessment - The quality assessment of the included studies was performed using the Newcastle-Ottawa Scale. Results Included studies - Thirty-two studies were included. There were 12 cohort studies, 5 case-control studies, 9 cross-sectional surveys and 6 case reports. The study population comprised 9371 individuals, of which 2671 were AAS users. Synthesis of results - AAS users had reduced levels of FSH and LH than the naïve population. These levels remained low for 3-6 months after stopping AAS. One year after stopping AAS, the users and naïve population had insignificant differences in FSH and LH values. The total testosterone (TT) levels were comparable in users and naïve populations at baseline, 3 months and 6 months after stopping, but at 1 year, TT values were lower in AAS users. Sperm concentration in AAS users and naïve population was similar, but sperm motility was lower in AAS users. The testicular size was lower in AAS users. The erectile function improved with AAS use, but on withdrawal, there was decreased libido and erectile dysfunction. Most AAS users need additional medications to mitigate detrimental effects on fertility. Description of the effect - AAS use negatively impacted the gonadotrophin levels and had lower sperm motility and testicular size. Strength - Comprehensive review of 32 publications, study population of 9371 individuals, of which 2671 were AAS users, meta-analysis of reproductive hormones, semen parameters and testis size. Limitations The limitations are small sample size of most of the studies, polypharmacy, lack of information on dosing and high heterogeneity. Interpretation AAS use is detrimental for sperm motility and has a partially reversible negative impact on male fertility. Users must be cautioned about its negative impact on libido and erectile function.Registration: PROSPERO Registration No. CRD42023411294.
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Affiliation(s)
- Prashant Motiram Mulawkar
- Urology, Tirthankar Superspeciality Hospital, Mumbai, India
- Department of Urology, GMC and SSH, Mumbai, India
- Urology, University of Edinburgh, Edinburgh, UK
| | | | - Vineet Gauhar
- Urology, Ng Teng Fong General Hospital, NUHS, Singapore
| | | | | | | | - Gopal Ramdas Tak
- Urology, Asian Institute of Nephrology and Urology, Hyderabad, Telangana, India
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