Increased atherothrombotic markers and endothelial dysfunction in steroid users

Eur J Prev Cardiol. 2013 Apr;20(2):195-201. doi: 10.1177/2047487312437062. Epub 2012 Feb 3.

Abstract

Background: The use of androgenic anabolic steroids (AAS) may be associated with changes in atherothrombotic markers and endothelial function. The purpose of this study was to compare atherothrombotic markers and endothelial function of AAS users and non-users.

Design: Cross-sectional study.

Methods: Ten athletes who were users of AAS (confirmed by urine analysis) and 12 non-user athletes were evaluated. Body weight, blood pressure, exercise load (hours/week), complete blood count (CBC), platelets, fibrinogen, lipids, high-sensitivity C-reactive protein (hs-CRP), follicle-stimulating hormone, testosterone and estradiol were measured. Endothelium-dependent and independent functions were assessed by brachial artery ultrasound.

Results: AAS users had higher body mass and blood pressure (p < 0.05). Platelet count was higher whereas HDL-cholesterol was lower in AAS users compared with non-users (p < 0.05). Levels of hs-CRP were higher in AAS users (p < 0.001). Follicle-stimulating hormone was suppressed in all users and not suppressed in non-users (p < 0.001). Compared with non-users, flow-mediated dilation was significantly reduced in AAS users (p = 0.03), whereas endothelium-independent function was similar in both groups. Additionally, flow-mediated dilation was positively associated with levels of HDL- cholesterol (r = 0.49, p = 0.03).

Conclusions: AAS users present important changes in blood lipids as well as in inflammatory markers, which are compatible with increased cardiovascular risk. Furthermore, this profile is accompanied by a reduction in the endothelial function.

MeSH terms

  • Adolescent
  • Adult
  • Anabolic Agents / adverse effects*
  • Anabolic Agents / urine
  • Analysis of Variance
  • Atherosclerosis / blood
  • Atherosclerosis / chemically induced*
  • Atherosclerosis / diagnosis
  • Atherosclerosis / physiopathology
  • Biomarkers / blood
  • Biomarkers / urine
  • Blood Cell Count
  • Blood Pressure / drug effects
  • Body Weight / drug effects
  • Brachial Artery / diagnostic imaging
  • Brachial Artery / drug effects*
  • Brachial Artery / physiopathology
  • Case-Control Studies
  • Chi-Square Distribution
  • Cross-Sectional Studies
  • Doping in Sports
  • Endothelium, Vascular / diagnostic imaging
  • Endothelium, Vascular / drug effects*
  • Endothelium, Vascular / physiopathology
  • Humans
  • Inflammation Mediators / blood
  • Lipids / blood
  • Male
  • Performance-Enhancing Substances / adverse effects*
  • Performance-Enhancing Substances / urine
  • Risk Factors
  • Steroids / adverse effects*
  • Steroids / urine
  • Substance Abuse Detection / methods
  • Thrombosis / blood
  • Thrombosis / chemically induced*
  • Thrombosis / diagnosis
  • Thrombosis / physiopathology
  • Ultrasonography
  • Urinalysis
  • Vasodilation / drug effects*
  • Young Adult

Substances

  • Anabolic Agents
  • Biomarkers
  • Inflammation Mediators
  • Lipids
  • Performance-Enhancing Substances
  • Steroids