Severe Cardiac and Metabolic Pathology Induced by Steroid Abuse in a Young Individual

Androgenic-Anabolic Steroids (AAS) abuse is known to play an important role in causing the systemic inflammatory response and multiple-organ dysfunction in healthy individuals. Although many of the undesirable effects of steroid abuse have been reported, at present, little is known about the effect of anabolic supplements and the correlation between cardiac and metabolic pathology. This paper presents a case of a 25 year old patient with a complex medical history after 6 months of steroid administration. Myocardial infraction, dyslipidemia, obesity, hyperuricemia, secondary diabetes, and chronic renal disease were identified after clinical and para-clinical examinations. The particularities of this case were interpreted in the context of a literature review, highlighting the effect of multi-organ damage as a result of the uncontrolled use of anabolic steroid supplements.

Anabolic–Androgenic Steroid Abuse among Gym Users, Eastern Province, Saudi Arabia

Background and Objectives: The main aim of the present study was to assess the use of androgenic–anabolic steroids (AAS) and to investigate its potentially unfavorable effects among gym members attending gym fitness facilities in Eastern Province, Saudi Arabia. Materials and Methods: A cross-sectional questionnaire-based study was carried out during the summer of 2017. Male gym users in the Eastern Province region of Saudi Arabia were the respondents. Information on socio-demographics, use of AAS, knowledge, and awareness about its side effects were collected using a self-administered questionnaire. Results: The prevalence of AAS consumption among trainees in Eastern Province was 21.3%. The percentage was highest among those 26–30 years of age (31.9%), followed by the 21–25 (27.4%) (p = 0.003) age group. Participants in the study were not aware of the potential adverse effects of AAS use. Adverse effects experienced by 77% of AAS users include psychiatric problems (47%), acne (32.7%), hair loss (14.2%), and sexual dysfunction (10.7%). Moreover, it appears that trainers and friends are major sources (75.20%) for obtaining AAS. Conclusion: AAS abuse is a real problem among gym members, along with a lack of knowledge regarding its adverse effects. Health education and awareness programs are needed not only for trainees, but also for trainers and gym owners as they are reportedly some of the primary sources of AAS.

Desmosomal vulnerability renders left atria more susceptible to detrimental effects of androgenic anabolic steroids

Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): CATCH ME Foundation Leducq BACKGROUND In cardiac myocytes, desmosomal proteins and ion channels form macromolecular complexes important for maintaining cell adhesion and electrical integrity. High serum levels of androgenic anabolic steroids (AAS) promote cardiac muscle growth, but any detrimental impact on atrial gene transcription and/or electrophysiological function is unknown. PURPOSE To investigate the effects of chronic AAS exposure on atria in a mouse model with desmosomal impairment. METHODS Young (8-10 week) male wild-type (WT) and heterozygous plakoglobin-deficient (plako+/-) mice were challenged with the AAS dihydrotestosterone (DHT) or placebo for 6 weeks by osmotic mini pumps. RNA sequencing (n = 3-6 atria/group) revealed effects of genotype and DHT on left atrial (LA) transcription. Membrane-localised cardiac sodium channels (Nav1.5) were visualised using direct STochastic Optical Reconstruction Microscopy (dSTORM, n = 5-11 LA/group, 122 cells in total) and clustering of individual molecules was quantified using persistence-based clustering. Patch clamping of LA cardiac myocytes was used to record whole cell sodium currents (n = 4-5 LA/group, 77 cells in total). LA action potentials and conduction velocity were evaluated using microelectrode and optical mapping techniques (n = 5-9 LA/group). RESULTS DHT increased expression of pro-hypertrophic transcripts, e.g. Igf1, Mtpn, fibrosis-associated transcripts, e.g. Col1a1, Col3a1, Lox and pro-inflammatory transcripts, e.g. Ccl6, C7, in both WT and plako+/- LA. Despite Scn5a transcript levels being maintained, dSTORM identified a 29% reduction (p = 0.042) in the number of Nav1.5 localisations at the membrane of plako+/- DHT LA cardiomyocytes, and 25% fewer localisations (p = 0.005) were found within Nav1.5 clusters, compared to WT DHT. Electrophysiological methods revealed a significant reduction in peak sodium current density, decreased action potential amplitude and conduction slowing in plako+/- LA after exposure to DHT. CONCLUSION This data suggests that a reduction in plakoglobin expression predisposes atrial cardiomyocytes to detrimental electrophysiological effects of high testosterone levels. This is characterised by a perturbed spatial organisation of Nav1.5, decreased sodium current density and conduction slowing. Abstract Figure. Abstract Picture

Random forest model to identify factors associated with anabolic-androgenic steroid use

Background One of the types of doping that is commonly used by bodybuilders, is androgenic-anabolic steroids (AAS). The use of AAS besides violating sporting ethics would have serious consequences on physical and mental health statuses. This study aimed to determine the most important factors of using AAS among bodybuilders by prototype willingness model (PWM). Methods In this analytical cross-sectional study, 280 male bodybuilders were selected from the bodybuilding clubs in Hamadan city using multistage sampling in 2016. A self-administered questionnaire consisting of demographic information and constructs of the PWM was then used to collect data and random forest model was also applied to analyze the collected data. Results Behavioral willingness, attitude, and previous AAS use were found as the most important factors in determining the behavioral intention. Moreover, subjective norms, attitude, BMI, and prototypes were the factors with the greatest effect on predicting behavioral willingness of AAS use. As well, behavioral intention was observed to be more important than behavioral willingness for predicting of AAS use. Discussion The obtained results show that the reasoned action path has a greater impact to predict AAS use among bodybuilders compared to social reaction path.

The Prediction Factors of Anabolic-Androgenic Steroid Use among Bodybuilders: Application of Prototype Willingness Model

Background: One of the types of doping commonly used by bodybuilders is androgenic-anabolic steroids (AAS).The use of AAS in addition to violating sporting ethics, has serious consequences on physical and mental health. The purpose of this study was to determining the most important factors of AAS use among bodybuilders using prototype willingness model (PWM).Methods: In this analytical cross-sectional study, 280 male bodybuilders were selected using multistage sampling from the bodybuilding clubs in Hamadan city in 2016.A self-administered questionnaire consisting of demographic information and constructs of the PWM was used to collect data and random forest model was used to analyses the gathered data.Results: behavioral willingness, Attitude, previous AAS use were the most important factors in determining the behavioral intention. Subjective norms, attitude, BMI and prototypes were the factors that have the greatest impact on predicting of behavioral willingness of AAS use. Also behavioral intention was more important rather than behavioral willingness for predicting of AAS use.Discussion: The results based on PWM and random forest showed that the reasoned action path has a greater impact than social reaction path to predict AAS use among bodybuilders.

EDUCATIVE ASPECTS OF DOPING PREVENTION IN SCHOOL-AGED CHILDREN AND ADOLESCENTS

The aim of this study was to provide an overview of doping prevention strategies in school-aged children and adolescents. To preserve the spirit of sport, the Anti-Doping Code requires that each anti-doping organization should develop and implement education and prevention programs for athletes, including the young and support staff. Education programs that encourage respect, equity, and inclusion, are closely related to fairness and should be implemented in school-aged children. The focus on school-aged children is essential, since early adolescence is a critical stage associated with a distorted body image (muscle dysmorphia), which in turn can lead to deliberate use of prohibited substances (mostly androgenic anabolic steroids) or methods. Since adolescents are focused on the "here" and "now", the conception of anti-doping programs should emphasize the adverse effects of doping at the early stage of use, as well as a high probability of health consequences. Encouraging prevention should raise awareness of the recipients about adverse effects, which in turn should produce anti-doping behavior. Moreover, the goal of preventive actions should be the development of self-esteem, which equals the observance of rights and values of other people, and the ability to refuse through the strategy termed "A way to say: No".

Polycythemia: a mystery solved by history

Testosterone is responsible for increased muscle mass. Leaner body mass helps control weight and increases energy. High levels of testosterone help build muscles and also stimulate growth in strength. Androgenic-anabolic steroids (AAS) are drugs that are structurally related to the cyclic steroid rings system and have similar effects to testosterone in the body. Athletes who abuse steroids do so for muscle growth and quick recovery. Testosterone - whether it's injected, applied via a patch or cream, or taken orally - allows athletes to rapidly increase muscle mass beyond their usual capacity, and also reduces their recovery time which allows them to train continuously with little need to rest their bodies in between workouts. Physiologically, erythrocytosis is defined by an erythrocyte mass that exceeds 125% of that predicted for sex and body mass. Much of the concern with the use of testosterone involves increase in blood viscosity, resulting from increased red blood cell mass causing a potential increased risk for venous thromboembolism (VTE), myocardial infarction (MI), and cerebrovascular accidents (CVA). We report a case of secondary polycythemia related to testosterone therapy.