Homocysteine - A consequence of long term Anabolic- Androgenic steroid (AAS) abuse

Michael R Graham ^1*, Fergal M Grace ¹, Wyndham Boobier ¹, Dave Hullin ², Andrew Kicman ³, David Cowan ³, Bruce Davies ¹ and Julien S Baker ¹

¹ University of Glamorgan, United Kingdom
² Royal Glamorgan Hospital, United Kingdom
³ Kings College London, United Kingdom

^* To whom correspondence should be addressed. E-mail: drgraham{at}glam.ac.uk.

Accepted 14 February 2006

Abstract

Objectives: The long term effects (>20 years) of anabolic-androgenic steroid (AAS) use on plasma concentrations of homocysteine (HCY), folate, testosterone (T), sex hormone binding globulin (SHBG), free androgen index (FAI), urea, creatinine, haematocrit (HCT), vitamin B12 (B12), and urinary testosterone/epitestosterone (T/E) ratio, was examined in a cohort of self-prescribing bodybuilders.

Methods: Subjects (n = 40) were divided into four distinct groups: (1): (n=10) AAS users, still using (SU); (2): (n=10) AAS users, three months abstinent from AAS administration (SA); (3): (n=10) non-drug using bodybuilding controls (BC); (4): (n=10) sedentary male controls (SC).

Results: HCY was significantly higher in SU compared with BC, SC (P<0.01), and with SA (P<0.05). Fat free mass (FFM) was significantly higher in both groups of AAS users (P<0.01). Daily Energy Intake and Daily Protein Intake (%) were significantly higher in SU and SA (P<0.05), compared with BC and SC groups, but was unlikely to be responsible for the observed HCY elevations. HCT concentrations, were significantly higher in the SU group (P<0.01). A significant linear inverse relationship was observed between SHBG and HCY, in the SU group (r = -0.828, P<0.01), indicating a possible influence of the sex hormones in determining HCY levels.

Conclusions: With surmounting evidence linking AAS to adversely affecting certain clotting factors, the significantly higher levels of HCY and HCT observed in the SU group, suggests long term AAS users have increased risk of future thromboembolic events.

Key Words: bodybuilding, haematocrit, homocysteine, thromboembolism

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