title: Testosterone, sex hormone-binding globulin, lipoproteins, and vascular disease risk.
abstract: BACKGROUND
  That men have a higher risk of coronary heart disease has implicated testosterone as a risk factor. Lipoprotein levels have been reported to be altered by androgens, thus increasing the risk of coronary heart disease, myocardial infarction, and sudden death. The increasing abuse of anabolic steroids and reports of cases of sudden death and myocardial infarction among bodybuilders have raised concerns about an increase in cardiovascular risk for this population.
  
  
  METHODS
  Twelve competitive bodybuilders were recruited for a comprehensive study on the cardiovascular risks associated with use of anabolic steroids. Six competitive heavyweight bodybuilders ingesting self-directed regimens of anabolic steroids (steroid group) and six competitive heavyweight drug-free bodybuilders were used for cardiovascular risk assessment. Apolipoproteins A-I and B, total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglyceride, testosterone, and sex hormone-binding globulin levels were determined in each athlete.
  
  
  RESULTS
  Total, HDL and LDL cholesterol, apolipoproteins A-I and B, and triglyceride levels were significantly lower in members of the steroid group. As expected, testosterone level was significantly higher in members of the steroid group; sex hormone-binding globulin level was significantly lower. Apolipoprotein and lipoprotein levels were lower in members of the steroid group, whereas the total: HDL cholesterol ratio was significantly higher for members of the steroid group.
  
  
  CONCLUSIONS
  Consistently with previous reports, androgens were associated with decreases in HDL cholesterol and apolipoprotein A-I levels. However, androgens were also associated with reduced LDL cholesterol and apolipoprotein B levels. Despite the significantly higher total: HDL cholesterol ratio, the low serum total cholesterol levels (within the fifth percentile) and low plasma triglyceride levels in members of the steroid group raise questions concerning the exact role of androgens in increasing risk of cardiovascular disease.
authors.affiliation: Department of Biomedical Sciences, University of North Texas Health Science Center, Fort Worth 76107-2699, USA.
authors.forename: R D
authors.initials: RD
authors.lastname: Dickerman
authors.forename: W J
authors.initials: WJ
authors.lastname: McConathy
authors.forename: N Y
authors.initials: NY
authors.lastname: Zachariah
mesh_terms: D000328:Adult; D045930:Anabolic Agents / Q000009:adverse effects*; D001053:Apolipoproteins / Q000097:blood*; D002318:Cardiovascular Diseases / Q000209:etiology*; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood; D004300:Doping in Sports; D006801:Humans; D008297:Male; D012307:Risk Factors; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism*; D019966:Substance-Related Disorders / Q000097:blood* / Q000150:complications*; D013739:Testosterone / Q000097:blood*; D014280:Triglycerides / Q000097:blood; D014891:Weight Lifting
chemical_list: D045930:Anabolic Agents; D001053:Apolipoproteins; D012738:Sex Hormone-Binding Globulin; D014280:Triglycerides; D013739:Testosterone; D002784:Cholesterol