Androgenic anabolic steroids and arterial structure and function in male bodybuilders

[mick-G]

TweetMark A. Sader MBBS, FRACP*, †, Kaye A. Griffiths, DMU*, Robyn J. McCredie BSc*, David J. Handelsman MBBS, PhD, FRACP‡, § and David S. Celermajer MBBS, PhD, FRACP, , *, ‡, ||

* Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
† The Heart Research Institute, The University of Sydney, Sydney, Australia
‡ Department of Andrology, Concord Hospital, Sydney, Australia
§ The ANZAC Research Institute, The University of Sydney, Sydney, Australia
|| Department of Medicine, The University of Sydney, Sydney, Australia

Received 29 December 1999; revised 17 August 2000; accepted 28 September 2000. Available online 21 December 2000.




Abstract
OBJECTIVES

The study examined arterial and cardiac structure and function in bodybuilders using androgenic anabolic steroids (AAS), compared to non-steroid-using bodybuilder controls.

BACKGROUND

Adverse cardiovascular events have been reported in bodybuilders taking anabolic steroids. The cardiovascular effects of AAS, however, have not been investigated in detail.

METHODS

We recruited 20 male bodybuilders (aged 35 ± 3 years), 10 actively using AAS and 10 who denied ever using steroids. Serum lipid and hormone levels, carotid intima-media thickness (IMT), arterial reactivity, and left ventricular (LV) dimensions were measured. Vessel diameter was measured by ultrasound at rest, during reactive hyperemia (an endothelium-dependent response, leading to flow-mediated dilation, FMD), and after sublingual nitroglycerin (GTN, an endothelium-independent dilator). Arterial reactivity was also measured in 10 age-matched non-bodybuilding sedentary controls.

RESULTS

Use of AAS was associated with significant decreases in high density lipoprotein cholesterol, sex hormone binding globulin, testosterone and gonadotrophin levels, and significant increases in LV mass and self-reported physical strength (p < 0.05). Carotid IMT (0.60 ± 0.04 mm vs. 0.63 ± 0.07 mm), arterial FMD (4.7 ± 1.4% vs. 4.1 ± 0.7%) and GTN responses (11.0 ± 1.9% vs. 14.4 ± 1.7%) were similar in both bodybuilding groups (p > 0.2). The GTN responses were significantly lower and carotid IMT significantly higher in both bodybuilding groups, however, compared with the non-bodybuilding sedentary controls (p = 0.01).

CONCLUSIONS

Although high-level bodybuilding is associated with impaired vascular reactivity and increased arterial thickening, the use of AAS per se is not associated with significant abnormalities of arterial structure or function.

Abbreviations: AAS, androgenic anabolic steroids; BP, blood pressure; FMD, flow-mediated dilation; FSH, follicle-stimulating hormone; GTN, sublingual nitroglycerin; HDL, high density lipoprotein; IMT, intima-media thickness; LH, luteinizing hormone; LV, left ventricle/left ventricular; SHBG, sex hormone binding globulin
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TweetIn the same vane, not so good:

Flow-mediated, endothelium-dependent vasodilatation is impaired in male body builders taking anabolic-androgenic steroids.

Ebenbichler CF, Sturm W, Ganzer H, Bodner J, Mangweth B, Ritsch A, Sandhofer A, Lechleitner M, Foger B, Patsch JR.

Universitatsklinik fur Innere Medizin, Universitat Innsbruck, Innsbruck, Austria. christoph.ebenbichler@uibk.ac.at

Self-administration of anabolic-androgenic steroids to increase muscular strength and lean body mass has been used widely among athletes. Flow mediated dilatation (FMD) determined by ultrasound of the brachial artery is accepted as both an in vivo index of endothelial function and an indicator for future atherosclerosis. FMD was calculated in 20 male non-smoking body builders in different phases of their training cycle and in six male non-smoking control athletes. Ultrasound studies of the brachial artery were performed according to the protocol of Celermajer et al. Of the entire training cycle, work-out phase was training phase without actual intake of anabolic-androgenic steroids over 8 weeks; build-up phase included actual intake of anabolic-androgenic steroids; and competition phase consisted of 8 weeks post intake of anabolic-androgenic steroids. Baseline characteristics did not differ between body builder groups except for a higher weight in competition phase body builders. Hormonal analysis revealed suppressed luteinizing hormone and follicle stimulating hormone levels in build-up phase body builders. The lipid profiles showed a marked reduction of HDL-C in build-up phase body builders. FMD was reduced in body builders of all phases when compared to control athletes (work-out phase: 2.5+/-2.7%; build-up phase: 2.1+/-3.0%; competition phase: 0.4+/-2.9% vs. 10.9+/-4.4%, P<0.05 by pairwise comparison using Scheffe's test for work-out phase, build-up phase and competition phase vs. control athletes). The glyceryl trinitrate-induced vasodilatation was diminished, though not statistically significantly, in body builders when compared with control athletes. The differences in FMD persisted after adjustment for vessel size. Our data indicate that intake of anabolic-androgenic steroids is associated with both an atherogenic blood lipid profile and endothelial dysfunction and thus may pose an increased risk of atherosclerosis.

PMID: 11583730 [PubMed - indexed for MEDLINE]