Reversibility of the effects on blood cells, lipids, liver function and hormones in former anabolic-androgenic steroid abusers.
BACKGROUND
In contrast to the acute effects of anabolic-androgenic steroid (AAS) abuse, the long-term risk profile of former long-term abusers (ExA) is less clear.


METHODS
Blood parameters of 32 male bodybuilders and powerlifters were studied. Fifteen ExA had not been abusing AAS for at least 12-43 months on average (mean dosage 700 mg for 26 weeks per year over 9 years), 17 athletes (A) were still abusing AAS (750 mg for 33 weeks per 8 years).


RESULTS
Hemoglobin (+5%), leucocytes (+33%) and platelets (+38%) were significantly higher in A. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were higher, cholinesterase activity (CHE) lower in A (65+/-55, 38+/-27 and 3719+/-1528U/l) compared to ExA (24+/-10, 18+/-11 and 6345+/-975U/l; each P<0.001) with normal values for gamma-glutamyl transpeptidase (gamma-GT) and bilirubin. ALT, AST and CHE correlated significantly with the extent (duration and weekly dosage, expressed as a point score) of AAS abuse in A (r=0.68, 0.57 and -0.62; each P<0.01). Total and LDL-cholesterol were similar, HDL-cholesterol was distinctly lower in A than in ExA (17+/-11 and 43+/-11 mg/dl; P<0.001) and correlated negatively with the extent of AAS abuse (r=-0.50; P<0.05). Testosterone and estradiol were significantly higher, while LH, FSH and the sexual-hormone-binding (SHB) protein were lower in A than in ExA (each P<0.001). Two ExA had testosterone levels below the normal range.


CONCLUSIONS
The alterations in cell counts, HDL-cholesterol, liver function and most hormones of the pituitary-testicular axis induced by a long-term abuse of AAS were reversible after stopping the medication for over 1 year. In some ExA, an increased ALT activity and a depressed testosterone synthesis were found.
Urhausen
Axel
A
Faculty of Clinical Medicine, Institute of Sports and Preventive Medicine, University of Saarland, Germany. a.urhausen@rz.uni-sb.de
Torsten
Albers
A
Wilfried
Kindermann
K
D000328:Adult; D045930:Anabolic Agents / Q000009:adverse effects*; D001773:Blood Cells / Q000187:drug effects*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003402:Creatine Kinase / Q000378:metabolism; D004300:Doping in Sports; D004958:Estradiol / Q000097:blood; D006728:Hormones / Q000097:blood; D006801:Humans; D050356:Lipid Metabolism; D008099:Liver / Q000000981:diagnostic imaging / Q000187:drug effects*; D008297:Male; D013739:Testosterone / Q000097:blood; D013997:Time Factors; D014463:Ultrasonography
D045930:Anabolic Agents; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D006728:Hormones; D013739:Testosterone; D004958:Estradiol; D003402:Creatine Kinase