Homocysteine induced cardiovascular events: a consequence of long term anabolic-androgenic steroid (AAS) abuse.
OBJECTIVE
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.
Department of Exercise and Health Science, School of Applied Science, University of Glamorgan, Pontypridd, Wales, UK. drgraham@glam.ac.uk
M R
MR
Graham
F M
FM
Grace
W
W
Boobier
D
D
Hullin
A
A
Kicman
D
D
Cowan
B
B
Davies
J S
JS
Baker
D000328:Adult; D045930:Anabolic Agents / Q000009:adverse effects* / Q000494:pharmacology; D000704:Analysis of Variance; D002318:Cardiovascular Diseases / Q000097:blood / Q000139:chemically induced*; D004300:Doping in Sports; D006711:Homocystine / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013256:Steroids / Q000009:adverse effects* / Q000494:pharmacology; D019966:Substance-Related Disorders / Q000150:complications*; D014891:Weight Lifting
D045930:Anabolic Agents; D013256:Steroids; D006711:Homocystine