Effects of Low-to-Moderate Doses of Anabolic Steroids on Lipid Profile and Muscle Hypertrophy in Resistance Training Practitioners: A Systematic Review with Meta-Analysis

Abstract Background: The use of androgenic anabolic steroids (AAS) is prevalent among young bodybuilders, motivated by aesthetic results. Although the medical community condemns this practice for its potential deleterious effect, we must recognize the need for more scientific research on the likelihood and magnitude of the adverse events. Objective: To evaluate whether high-quality, scientific evidence supports that AAS negatively affect lipid profile and promote muscle hypertrophy in resistance training practitioners. Methods: A systematic review of the literature of randomized clinical trials was conducted in the PubMed / Medline, Scielo and Science direct databases. The searches were conducted by two independent researchers by June 2018. A significance level of 5% was considered in the analysis. Results: Six clinical trials involving 170 resistance training practitioners were included. A significant heterogeneity was found in studies evaluating the effects of AAS on lipid profile and muscle hypertrophy (I² = 97, 95 and 91%, respectively), with no significant effects on HDL-cholesterol (-5.62mg/dL, 95%CI −12.10, 0.86, p= 0.09), LDL-cholesterol (7.76 mg/dL, 95%CI −9.70, 25.23, p= 0.57) and muscle hypertrophy (2.44kg 95%CI 0.02, 4.86, p=0.05). Conclusion: Current evidence does not support that low-to-moderate doses of AAS cause serious negative effects on lipid profile or promote muscle hypertrophy in resistance training practitioners.

Determinação de estimulantes, esteroides anabolizantes, diuréticos e laxante por HPLC-DAD e LC-MS/MS em suplementos alimentares adulterados disponíveis no Brasil / Determination of stimulants, anabolic steroids, diuretics and laxative by HPLC-DAD and LC-MS/MS in adulterated dietary supplements available in Brazil

A adulteração de suplementos alimentares pela adição de substâncias farmacologicamente ativas e um problema que vem se agravando nos últimos anos. Essas substâncias são adicionadas intencionalmente nos produtos, com objetivo de melhorar a sua eficácia, sem que essa adição seja devidamente informada nos rótulos. O consumo de suplementos adicionados de substâncias farmacologicamente ativas nao declaras nos rótulos e, alem de um problema de saúde pública, um risco a carreira de atletas profissionais, quando se trata de doping no esporte. Neste trabalho foram desenvolvidos métodos analíticos baseados em cromatografia líquida para detecção de 19 substâncias farmacologicamente ativas em amostras de suplementos alimentares, nos niveis de contaminação cruzada e adulteração. Para tal, empregou-se a cromatografia líquida de alta eficiência acoplada a detector de arranjo de diodos (HPLC-DAD) e a cromatografia líquida acoplada a espectrometria de massas sequencial (LC-MS/MS). As substâncias investigadas apresentam ação androgênica e anabólica (i.e. testosterona, metiltestostetona, propionato de testosterona, decanoato de testosterona, trembolona, estanozolol, dehidroepiandrosterona, androstenediona, decanoato de nandrolona, oxandrolona e metasterona), estimulante (i.e. cafeína), anorexigena (i.e. sibutramina), diurética (i.e. amilorida, bumetanida, furosemida, hidroclorotiazida e clortalidona) e laxante (i.e. fenolftaleina). Entre os métodos de preparo de amostra avaliados (Quechers e extração sólido-líquido seguida de uma etapa de precipitação de proteína), a extração sólido-líquido empregando metanol como solvente extrator e ZnSO4 como agente precipitante apresentou-recuperação acima de 80% para todas as substâncias avaliadas, sendo selecionado para o fim deste estudo. Os métodos analíticos propostos apresentaram limites de detecção e de quantificação na faixa de contaminação, foram seletivos e lineares com r2 superior a 0,99 na faixa de concentração de interesse para todas as substâncias e valores de recuperação, precisão e exatidão dentro dos valores aceitáveis. Um conjunto amostral representativo dos suplementos alimentares comercializados no Brasil, constituído por 230 amostras, foi analisado sendo que mais de 25% do conjunto amostra foram positivos para cafeína (48), sibutramina (14), fenolftaleína (2) e furosemida (3), isoladas ou associadas entre si. Os métodos desenvolvidos utilizaram um preparo de amostra simples e apresentaram resultados satisfatórios para a investigação de possível adulteração ou contaminação com 19 das substâncias de interesse. Dos 58 suplementos alimentares adulterados, apenas 11 podem ser considerados adulterados por contaminação cruzada. Os demais, são consideradas adições dolosas por parte dos fabricantes com objetivo de melhorar a eficiência dos seus produtos. Os resultados aqui apresentados indicam a necessidade de ações mais efetivas por parte das autoridades sanitárias no sentido de fiscalizar com mais eficiência a produção e a comercialização desses produtos e alertar a população para que fiquem atentos a possível adulteração de suplementos alimentares e aos riscos associados ao consumo desses produtos

The adulteration of dietary supplements by the addition of pharmacologically active substances is a serious issue, which is aggravating steadily. These substances are added intentionally in various products, with the aim of improving their effectiveness, but without proper labeling stating so. In addition to a public health problem, the consumption ofsupplements added with undeclared pharmacologically active substances also represents a career risk for professional athletes when it comes to doping in sport. In the present work, analytical methods based on liquid chromatography were developed for the detection of 19 pharmacologically active substances in dietary supplement samples at the levels of crosscontamination and adulteration. For this purpose, high performance liquid chromatography/diode array detector (HPLC-DAD) and liquid chromatography/tandem mass spectrometry (LC-MS/MS) were used. The investigated substances comprise of androgenic and anabolic effects (ie testosterone, testosterone propionate, testosterone decanoate, trenbolone, stanozolol, dehydroepiandrosterone, androstenedione, nandrolone decanoate, oxandrolone and metasterone), stimulant (ie caffeine), anorexigenic (ie sibutramine), diuretic (ie amiloride, bumetanide, furosemide, hydrochlorothiazide and chlorthalidone) and laxative (ie phenolphthalein). Among the sample preparation methods evaluated (Quechers and solidliquid extraction followed by a protein precipitation step), solid-liquid extraction using methanol as extraction solvent and ZnSO4 as the precipitating agent has been chosen as it has shown recovery values above 80% for all evaluated substances. The proposed analytical methods had limits of detection and quantification within the contamination range, they were also selective and linear showing r2 values higher than 0.99 in the concentration range of interest for all substances and accuracy within acceptable values. A representative sampling of dietary supplements marketed in Brazil, consisting of 230 samples, was analyzed and more than 25% have shown to be positive for caffeine (48), sibutramine (14), phenolphthalein (2) and furosemide (3), isolated or associated with each other. The methods developed used a simple sample preparation and presented satisfactory results for the investigation of possible adulteration or cross-contamination for the 19 of the substances of interest. From a total of 58 adulterated dietary supplements, only 11 could be considered adulterated by crosscontamination. The remaining are considered to be intentional additions by manufacturers in order to improve the efficiency of their products. The results presented in this study indicate the need for more effective measures by the health authorities towards the production and marketing of these products so that the general public is aware of their potential adulteration and the risks associated with their consumption

Uso de Esteroides Anabólicos en Jóvenes de Asunción / Anabolic Steroid Use in Young People of Asuncion

Los esteroides anabólicos típicamente usados por jóvenes, atletas y culturistas para incrementar el musculo y la fuerza son peligrosos, están accesibles, y se prescriben de manera errónea como eficaces, pero con riesgo bajo. No solo los atletas consumen esteroides anabólicos. Algunos jóvenes los toman para lucir más musculosos o para quemar grasa. El objetivo del estudio fue identificar los factores asociados al uso de anabólicos esteroides en jóvenes de 16 a 25 años que asisten al Gimnasio Fitness Family Caff de Asunción, conocer los datos socio-demográficos, caracterizar los conocimientos y el uso de esteroides anabólicos en el gimnasio y determinar el factor de consumo de esteroides anabólicos de acuerdo a la práctica en el gimnasio. Estudio tipo observacional descriptivo de corte transversal que contó con la participación de 41 jóvenes provenientes en su mayoría de Asunción. En cuanto a los factores se determinó que su uso está motivado por mejorar el aspecto físico, es decir, por un factor estético al igual que por la participación en competencias fitness

Anabolic steroids, typically used by young people, athletes and bodybuilders to increase muscle and strength, are dangerous, accessible and are prescribed incorrectly as effective, but with low risk. Not only athletes consume anabolic steroids. Some young people take them to look more muscular or for fat burning. The study had the following objectives: To identify factors associated with the use of anabolic steroids in 16 to 25 years young people who attend the Family Fitness Caff Gym in Asuncion, to know the socio-demographic data, characterize the knowledge and use of anabolic steroids in the gym, and determine the consumption factor of anabolic steroids according to the practice in the gym. This was an observational descriptive cross-sectional study. The study had the participation of 41 young people, mostly from Asuncion. In relation to the factors, it was determined that their use was motivated to improve their physical appearance; this is to say, for an aesthetic factor as well as for the participation in fitness competitions.

Nefrocalcinose associada ao uso de esteroide anabolizante / Nephrocalcinosis associated with the use of anabolic steroid

Os esteroides anabolizantes têm sido usados como arma terapêutica em diversas condições clínicas. Entretanto, o uso abusivo e indiscriminado, associado a outros suplementos nutricionais, tem gerado efeitos adversos graves. Relato do caso: Sexo masculino, 21 anos, admitido com náuseas, astenia, hiporexia, cefaleia e hipertensão arterial. Exames no sangue evidenciaram Cr: 3,9 mg/dl U:100 mg/dl e Cálcio total 14 mg/dl. Ultrassonografia e biópsia renal compatíveis com nefrocalcinose. Houve melhora gradativa da função renal e da calcemia após hidratação vigorosa e furosemida. Entretanto, após 1 ano, persistiram depósitos renais de cálcio e relação córticomedular reduzida ao ultrassom e creatinina estável em 1,4 mg/dl. Casos anteriores evidenciaram necrose tubular aguda e nefrite intersticial com poucos depósitos de cálcio no interstício renal. Nesse caso, encontramos nefrocalcinose acentuada associada à nefroesclerose. O objetivo deste estudo é relatar a ocorrência de injúria renal aguda com nefrocalcinose associada ao uso de esteroide anabolizante e oferecer uma revisão do assunto. .

The anabolic steroid have been used as a therapeutic tool in various clinical conditions. However, indiscriminate use associated with other nutritional supplements has generated serious adverse effects. Case report: Male, 21 years old, admitted with nausea, fatigue, appetite loss, headache and hypertension. Blood tests showed Cr: 3.9 mg% U: 100 mg% and Total Calcium 14 mg/dl. Ultrasonography and renal biopsy were consistent with nephrocalcinosis. There has been gradual improvement in renal function and calcium levels after vigorous hydration and furosemide. However, after 1 year, renal calcium deposits persist, corticomedullary ratio reduced in ultrasound and stable creatinine of 1.4 mg/dl. Previous cases showed acute tubular necrosis and interstitial nephritis with little calcium deposits in the renal interstitium. In this case we found severe nephrocalcinosis associated with nephrosclerosis. Our objective is to report the occurrence of acute kidney Injury with nephrocalcinosis associated with use of anabolic steroid and provide a review of the matter. .

Erythropoietic response to androgen replacement therapy Erythropoietic and role of IL-6 in aging male rats

Changes in iron status and bone marrow Junctions are frequently observed in the elderly. These phenomena are often associated with chronic diseases and/or neoplcfsmas. In a minority of elderly subjects; it is not possible to identify the causes of anemia. This study was carried out to clarify the functional capacity of the erthropoietic tissues of the aged rats, to investigate the role of IL-6 in erthropoietic activity, and to evaluate the short-term testosterone therapy. Thirty healthy male Sprague-Dawley rats were divided according to their age into group I [16-week-old; n = 6], group II [48-week-old; n=12], group III [72-week-old; n=I2]. Six rats enrolled in each elderly group [groups II and III] received s.c. testosterone propionate; 2 mg/100 g body weight every other day for 10 days [Groups lIb and Illb]. The remaining rats not received testesterone were named groups [Ila and IlIa]. One day after the last injection, bone marrow aspirates were performed to evaluate the erthropoietic activity and iron stores in the erythroid precursors. In addition, a peripheral haemogram and determination of serum levels of iron, TIBC, IL-6, and free testosterone were done. Significant age-linked changes were observed in the form of decreased serum levels of free testosterone, IL-6, TIBC, RBCs count, and Hb levels as well as an increase in serum iron level in groups Ila and IIla. Bone marrow hypocellularity with a decrease in the amount of iron storage were especially remarkable in Group IlIa. Moreover improvement in the function of erythropoietic tissues in Group lib indicated by erythroid hyperplasia and an increase in the amounts of iron storage. However, reduced serum IL-6 was not affected by testosterone therapy. These data reveal that senile anemias are of hypoproliferaitue character. Testosterone and IL-6 may be, at least in part, the important factors in determining an age-associated decrease in erythropoiesis