Effects of androgenic-anabolic steroids on apolipoproteins and lipoprotein (a)
Effects of androgenic-anabolic steroids on apolipoproteins and lipoprotein (a)
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DOI：
10.1136/bjsm.2003.000199
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发表时间：
2004-06-01
影响因子：
18.4
通讯作者：
Wolffenbuttel, BHR
中科院分区：
文献类型：
--
作者：
Hartgens, F;Rietjens, G;Wolffenbuttel, BHR
目的：研究两种不同的雄激素合成代谢类固醇（AAS）给药方案对血脂和脂蛋白的影响，以及停药后这些变量的恢复情况，作为健康男性力量型运动员心血管疾病风险的指标。方法：在一项非盲研究中，（研究1）在19名自我服用AAS 8周或14周的受试者和16名未服用AAS的志愿者中评估了血清脂蛋白和脂质。在随机双盲，安慰剂对照设计，肌肉注射癸酸诺龙（200毫克/周）八周对相同的变量在16健美运动员的影响进行了研究（研究2）.测定空腹血清总胆固醇、甘油三酯、HDL-胆固醇（HDL-C）、HDL 2-胆固醇（HDL 2-C）、HDL 3-胆固醇（HDL 3-C）、载脂蛋白A1（Apo-A1）、载脂蛋白B（Apo-B）和脂蛋白（a）（Lp（a））浓度。在研究1中，AAS给药导致血清HDL-C浓度降低，（从1.08（0.30）到0.43）（0.22 mmol/l）、HDL2-C（从0.21（0.18）到0.05）（0.03）mmol/l），HDL3-C Apo-A1从0.87（0.24）mmol/l增加到0.40（0.20）mmol/l，Apo-A1从1.41（0.27）g/l增加到0.71（0.34）g/l，而Apo-B从0.96（0.13）g/l增加到1.32（0.28）g/l。血清Lp（a）从189（315）U/l降至32（63）U/l。总胆固醇和甘油三酯没有显著变化。AAS给药8周和14周后的变化相当。对照品未发生变化。AAS停止后6周，血清HDL-C、HDL 2-C、Apo-A1、Apo-B和Lp（a）仍未恢复至基线浓度。AAS给药14周与给药8周相比，恢复至治疗前浓度较慢。在研究2中，癸酸诺龙在干预4周和8周后以及停药6周后均未影响血清甘油三酯、总胆固醇、HDL-C、HDL 2-C、HDL 3-C、Apo-A1和Apo-B浓度。然而，在癸酸诺龙组中，Lp（a）浓度从103（68）U/l显著降低至65（44）U/l，在安慰剂组中观察到从245（245）U/l降低至201（194）U/l。干预期后6周，Lp（a）浓度已恢复到基线值，在两个group.Conclusions：自我管理的几个AASs同时为8或14周的脂质和脂蛋白产生相当深刻的不利影响，导致增加致动脉粥样硬化的血脂谱，尽管对Lp（a）浓度的有益影响。这些变化在AAS停药后持续存在，正常化取决于药物滥用的持续时间。癸酸诺龙给药8周不影响脂质和脂蛋白浓度，尽管它可能选择性地降低Lp（a）浓度。这对动脉粥样硬化形成的影响仍有待确定。
Objectives: To investigate the effects of two different regimens of androgenic-anabolic steroid (AAS) administration on serum lipid and lipoproteins, and recovery of these variables after drug cessation, as indicators of the risk for cardiovascular disease in healthy male strength athletes.Methods: In a non-blinded study ( study 1) serum lipoproteins and lipids were assessed in 19 subjects who self administered AASs for eight or 14 weeks, and in 16 non-using volunteers. In a randomised double blind, placebo controlled design, the effects of intramuscular administration of nandrolone decanoate ( 200 mg/week) for eight weeks on the same variables in 16 bodybuilders were studied ( study 2). Fasting serum concentrations of total cholesterol, triglycerides, HDL-cholesterol (HDL-C), HDL2-cholesterol (HDL2-C), HDL3-cholesterol (HDL3-C), apolipoprotein A1 (Apo-A1), apolipoprotein B (Apo-B), and lipoprotein ( a) ( Lp(a)) were determined.Results: In study 1 AAS administration led to decreases in serum concentrations of HDL-C ( from 1.08 (0.30) to 0.43 (0.22) mmol/l), HDL2-C ( from 0.21 (0.18) to 0.05 (0.03) mmol/l), HDL3-C (from 0.87 (0.24) to 0.40 (0.20) mmol/l, and Apo-A1 ( from 1.41 (0.27) to 0.71 (0.34) g/l), whereas Apo-B increased from 0.96 (0.13) to 1.32 (0.28) g/l. Serum Lp( a) declined from 189 ( 315) to 32 ( 63) U/l. Total cholesterol and triglycerides did not change significantly. Alterations after eight and 14 weeks of AAS administration were comparable. No changes occurred in the controls. Six weeks after AAS cessation, serum HDL-C, HDL2-C, Apo-A1, Apo-B, and Lp( a) had still not returned to baseline concentrations. Administration of AAS for 14 weeks was associated with slower recovery to pretreatment concentrations than administration for eight weeks. In study 2, nandrolone decanoate did not influence serum triglycerides, total cholesterol, HDL-C, HDL2-C, HDL3-C, Apo-A1, and Apo-B concentrations after four and eight weeks of intervention, nor six weeks after withdrawal. However, Lp( a) concentrations decreased significantly from 103 (68) to 65 (44) U/l in the nandrolone decanoate group, and in the placebo group a smaller reduction from 245 (245) to 201 (194) U/l was observed. Six weeks after the intervention period, Lp( a) concentrations had returned to baseline values in both groups.Conclusions: Self administration of several AASs simultaneously for eight or 14 weeks produces comparable profound unfavourable effects on lipids and lipoproteins, leading to an increased atherogenic lipid profile, despite a beneficial effect on Lp( a) concentration. The changes persist after AAS withdrawal, and normalisation depends on the duration of the drug abuse. Eight weeks of administration of nandrolone decanoate does not affect lipid and lipoprotein concentrations, although it may selectively reduce Lp( a) concentrations. The effect of this on atherogenesis remains to be established.