title: Multivitamins and phospholipids complex protects the hepatic cells from androgenic-anabolic-steroids-induced toxicity.
abstract: BACKGROUND
  Androgenic-anabolic-steroids (AAS)-induced hepatotoxicity typically occurs with C-17 alkylated oral agents abused by exercising individuals at clinically recommended doses. Injectable compounds appear to have the same risk for hepatotoxicity, but are applied in doses three to six times higher than clinically recommended. AAS users occasionally try to avoid the well-known hepatotoxic effects associated with the abuse of a multitude of AAS agents, by using the pharmaceutical agent compound N a phospholipid/vitamin preparation.
  
  
  OBJECTIVE
  The investigation of the actual hepatoprotective effect of compound N against AAS-induced toxicity.
  
  
  METHODS
  This was an observational cohort study of 320 athletes; 160 were AAS users and the other 160 were not abusing any substances. Of the 160 users, 44 were using AAS and compound N (group A), and 116 were using solely AAS (group B). The 160 athletes abstaining from substances abuse acted as controls (group C). All athletes were tested for alterations in serum levels of hepatic enzymes. Enzyme levels before the study's onset and after the end of the 8-week AAS regimes were compared among the three groups, in order to delineate the hepatoprotective effect of compound N.
  
  
  RESULTS
  Prior to our research all groups showed normal values in all enzymes except creatine kinase (CK). After the 8-week period, CK levels were slightly lower in group A, but without variation in Groups B and C; -Glutamyl Transferase (GT) levels remained normal. Groups A and C had no elevations in any of the enzymes, except CK, while in group B all enzymes' values were elevated above the normal range. The only factor differentiating AAS users in group A from those in group B was the use of compound N, thus the results being suggestive of the compound's detoxification effect. The severity of AAS abuse was positively associated with the degree of changes ( values) in all measured enzymes except GT and CK.
  
  
  CONCLUSIONS
  Previous suggestions that serum hepatic enzyme elevations in exercising AAS abusers are connected to muscle fiber damage rather than the abuse itself, are contradicted by our results. Since all AAS abusing athletes were prone to exhibit elevations in enzymes' values, the mean values of group A were to be similar to those observed in group B, exceeding normal values. The group hepatic enzyme values of group B were significantly higher than the group C (control). Notably, group A did not have any statistically significant difference in the hepatic enzyme values compared to group C. The effect of exercise on these enzymes' elevations was ruled out by the comparability of training regimens and AAS toxicity was correlated to the severity of AAS abuse.
authors.affiliation: Department of Endocrinology, Thessaly University Medical School, Larissa, Greece. tpsportmed@the.forthnet.gr
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Pagonis
authors.forename: George N
authors.initials: GN
authors.lastname: Koukoulis
authors.forename: Christos S
authors.initials: CS
authors.lastname: Hadjichristodoulou
authors.forename: Paraskevi N
authors.initials: PN
authors.lastname: Toli
authors.forename: Nikiforos V
authors.initials: NV
authors.lastname: Angelopoulos
mesh_terms: D000328:Adult; D045930:Anabolic Agents / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury; D015331:Cohort Studies; D004300:Doping in Sports; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008099:Liver / Q000187:drug effects* / Q000473:pathology; D008107:Liver Diseases / Q000517:prevention & control*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D010743:Phospholipids / Q000627:therapeutic use*; D013177:Sports; D019966:Substance-Related Disorders / Q000150:complications; D014815:Vitamins / Q000627:therapeutic use*
chemical_list: D045930:Anabolic Agents; D004338:Drug Combinations; D010743:Phospholipids; D014815:Vitamins