Article Text

PDF
Homocysteine induced cardiovascular events: a consequence of long term anabolic-androgenic steroid (AAS) abuse
  1. M R Graham1,
  2. F M Grace1,
  3. W Boobier1,
  4. D Hullin2,
  5. A Kicman3,
  6. D Cowan3,
  7. B Davies1,
  8. J S Baker1
  1. 1Department of Exercise and Health Science, School of Applied Science, University of Glamorgan, Pontypridd, Wales, UK
  2. 2Department of Pathology, Royal Glamorgan Hospital, Mid-Glamorgan, Wales, UK
  3. 3Drug Control Centre, Kings College London, London, UK
  1. Correspondence to:
 Michael R Graham
 Health and Exercise Science Research Unit, School of Applied Science, University of Glamorgan, CF37 1DL, UK; drgraham{at}glam.ac.uk

Abstract

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

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

Results: HCY levels were significantly higher in SU compared with BC and SC (p<0.01), and with SA (p<0.05). Fat free mass was significantly higher in both groups of AAS users (p<0.01). Daily energy intake (kJ) and daily protein intake (g/day) were significantly higher in SU and SA (p<0.05) compared with BC and SC, but were unlikely to be responsible for the observed HCY increases. HCT concentrations were significantly higher in the SU group (p<0.01). A significant linear inverse relationship was observed in the SU group between SHBG and HCY (r = −0.828, p<0.01), indicating a possible influence of the sex hormones in determining HCY levels.

Conclusions: With mounting evidence linking AAS to adverse effects on some clotting factors, the significantly higher levels of HCY and HCT observed in the SU group suggest long term AAS users have increased risk of future thromboembolic events.

  • AAS, anabolic-androgenic steroid
  • B12, vitamin B12
  • BC, bodybuilding controls
  • FAI, free androgen index
  • FFM, fat free mass
  • FFMI, fat free mass index
  • HCT, haematocrit
  • HCY, homocysteine
  • ROS, reactive oxygen species
  • SA, AAS abstinent subjects
  • SC, sedentary controls
  • SD, standard deviation
  • SHBG, sex hormone binding globulin
  • SU, AAS using subjects
  • TBM, total body mass
  • T/E, testosterone/epitestosterone
  • tHCY, total HCY
  • bodybuilding
  • haematocrit
  • homocysteine
  • thromboembolism
View Full Text

Statistics from Altmetric.com

Footnotes

  • Published Online First 17 February 2006

  • Competing interests: none declared.

  • Ethical approval for this study was obtained from the university ethical committee and all subjects involved, having read experimental details, provided written consent. AAS using participants were recruited from a database of subjects who had been involved in previous studies.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.