Anabolic-androgenic steroid use among bodybuilders in Erbil city

Background and objective: Anabolic-androgenic steroids are synthetic testosterone derivatives with a longer duration of action than physiological androgens. They are abused by bodybuilders because of their potential to enhance muscle strength. Serious medical and psychological complications may be associated with their non-medical use. This study aimed to determine the prevalence of anabolic androgenic steroids among bodybuilders and their awareness of health-related risks. Methods: A cross-sectional study was carried out from the 1st of January 2019 to the end of July 2019 in 18 randomly selected gym centers in Erbil city, Iraq using stratified random sampling. A self-administered questionnaire was distributed to 400 bodybuilders to assess the prevalence and knowledge of using Anabolic-androgenic steroids. Results: The study showed a high prevalence of Anabolic-androgenic steroid consumption (26.3%) among gym users in Erbil city. Anabolic-androgenic steroid use was significantly higher among participants with a longer duration of bodybuilding practice ≥4 years (P = 0.001). Anabolic-androgenic steroid abuse was significantly associated with drinking alcohol, smoking cigarettes, and using growth hormones. Trainers were the commonest source of recommendation. Conclusion: The prevalence of anabolic androgenic steroids abuse is high among bodybuilders in Erbil city. Public health awareness is essential and may help avoid the propagation of the problem. Keywords: Anabolic steroids; Gym users; Bodybuilders; Knowledge, Erbil.

Advances in the Determination of Anabolic-Androgenic Steroids: From Standard Practices to Tailor-Designed Multidisciplinary Approaches

Anabolic-androgenic steroids (AASs), a group of compounds frequently misused by athletes and, unfortunately, also by the general population, have lately attracted global attention; thus, significant demands for more precise, facile, and rapid AAS detection have arisen. The standard methods ordinarily used for AAS determination include liquid and gas chromatography coupled with mass spectrometry. However, good knowledge of steroid metabolism, pretreatment of samples (such as derivatization), and well-trained operators of the instruments are required, making this procedure expensive, complicated, and not routinely applicable. In the drive to meet current AAS detection demands, the scientific focus has shifted to developing novel, tailor-made approaches leading to time- and cost-effective, routine, and field-portable methods for AAS determination in various matrices, such as biological fluids, food supplements, meat, water, or other environmental components. Therefore, herein, we present a comprehensive review article covering recent advances in AAS determination, with a strong emphasis on the increasingly important role of chemically designed artificial sensors, biosensors, and antibody- and fluorescence-based methods.

Anabolic-Androgenic Steroid Misuse: Mechanisms, Patterns of Misuse, User Typology, and Adverse Effects

Anabolic-androgenic steroids (AAS) encompass a broad group of natural and synthetic androgens. AAS misuse is highly prevalent on a global scale, with the lifetime prevalence of AAS misuse in males being estimated to be around 6%, with 15 to 25% of male gym attendees using it at any one time. AAS are associated with sudden cardiac death, neuropsychiatric manifestations, and infertility. The average AAS user is unlikely to voluntarily declare their usage to a physician, with around 1 in 10 actively engaging in unsafe injection techniques. The aim of this paper is to review the current evidence base on AAS with emphasis on mechanisms of action, adverse effects, and user profiles that are most likely to engage in AAS misuse. This paper also reviews terminologies and uses methods specific to the AAS user community.

799 Biventricular dysfunction and lung congestion in athletes on anabolic androgenic steroids: a speckle tracking and stress lung echocardiography analysis

Aims The real effects of the chronic consumption of anabolic–androgenic steroids (AAS) on cardiovascular structures are subjects of intense debate. Aim of the study was to detect by speckle tracking echocardiography (STE) right ventricular (RV) and left ventricular (LV) dysfunction at rest and during exercise stress echocardiography (ESE) in athletes abusing AAS. Methods and results 115 top-level competitive bodybuilders were selected (70 males), including 65 athletes misusing AAS for at least 5 years (users), 50 anabolic-free bodybuilders (non-users), compared to 50 age- and sex-matched healthy sedentary controls. Standard Doppler echocardiography, STE analysis, and lung ultrasound at rest and at peak supine-bicycle ESE were performed. Athletes showed increased LV mass index, wall thickness, and RV diameters compared with controls, whereas LV ejection fraction was comparable within the groups. LA volume index, LV and RV strain, and LV E/Em were significantly higher in AAS users. Users showed more B-lines during stress (median 4.4 vs. 1.25 in controls and 1.3 in non-users, P < 0.01 vs. users). By multivariable analyses, LV E/Ea (beta coefficient = 0.35, P < 0.01), PASP (beta = 0.43, P < 0.001) at peak effort, and number of weeks of AAS use per year (beta = 0.45, P < 0.001) emerged as the only independent determinants of resting RV lateral wall peak systolic two-dimensional strain. In addition, a close association between resting RV myocardial function and VO2 peak during ESE was evidenced (P < 0.001), with a powerful incremental value with respect to clinical and standard echocardiographic data. Conclusions STE represents a promising technique to assess RV myocardial function in athletes abusing steroids. AAS users showed a more impaired RV deformation, closely associated with reduced functional capacity during physical effort, and—during exercise—more pulmonary congestion.

Interaction of high-intensity endurance exercise and nandrolone on cardiac remodeling: role of adipo-cardiac axis

Objectives Given the cardiac pathological remodeling following to anabolic androgenic steroids (AASs) consumption, we examined the effect of chronic administration of nandrolone decanoate with high-intensity endurance exercise on the left ventricular hypertrophy index, levels of hydroxyproline, tumor necrosis factor-alpha (TNF-α), adiponectin (APN) and its receptors (AdipoR1 and AdipoR2) expression in rats’ hearts. Methods The male Wistar rats randomly divided to six groups included the control (CTL), exercise (Ex), nandrolone (Nan), vehicle (Arach), trained vehicle (Ex + Arach), and trained nandrolone (Ex + Nan) groups that were treated for eight weeks. Results Nandrolone consumption significantly enhanced the hypertrophy index (p<0.05) and exercise intensified this effect. It also increased the level of cardiac hydroxyproline (p<0.001), however exercise completely masked this effect. The values of TNF-α protein and AdipoR1 protein significantly increased in trained nandrolone-treated (Ex + Nan) group in comparison with CTL group (p<0.05), however, did not show significant alteration in Nan or Ex groups. High-intensity endurance exercise significantly enhanced the AdipoR2 protein (p<0.05), but, co-administration of nandrolone with exercise prevented this effect. The mRNA expression of AdipoR1 significantly reduced in the animals that received nandrolone for eight weeks and exercise recovered this effect (p<0.001). Conclusions Despite an additive effect of high-intensity endurance exercise plus nandrolone on TNF-α level, their effects on hydroxyproline and APN receptors expression is incompatible in heart of rat. It is suggests a part of beneficial regulatory role of endurance exercise against nandrolone induced heart remodeling may apply through modulation of APN system.

Quantitative and qualitative analysis of anabolic androgenic steroids found on the black market – A protocol for a systematic review

Review question / Objective: With this systematic literature review we aim to assess published data on the quality and quantity of anabolic androgenic steroids (AAS) found on the black market to further determine the proportions of original, substandard, and counterfeit drugs. To our knowledge this is the first systematic literature review analyzing the quality and quantity of blackmarked anabolic steroids within the published literature. Condition being studied: AAS are synthetic, or human-made, variations of the male sex hormone testosterone that are widely abused by athletes for its anabolic effect on the muscle, thus are a convenient and easy method to improve body image and sport performance goals. Fake AAS, commonly acquired from the black market, pose a significant risk to individual and public health.