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多种维生素与磷脂复合物可保护肝细胞免受雄激素同化类固醇诱导的毒性影响。

Multivitamins and phospholipids complex protects the hepatic cells from androgenic-anabolic-steroids-induced toxicity.

作者信息

Pagonis Thomas A, Koukoulis George N, Hadjichristodoulou Christos S, Toli Paraskevi N, Angelopoulos Nikiforos V

机构信息

Department of Endocrinology, Thessaly University Medical School, Larissa, Greece.

出版信息

Clin Toxicol (Phila). 2008 Jan;46(1):57-66. doi: 10.1080/15563650701590910.

Abstract

INTRODUCTION

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.

PRIMARY OBJECTIVE

The investigation of the actual hepatoprotective effect of compound N against AAS-induced toxicity.

METHODOLOGY

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.

摘要

引言

雄激素同化类固醇(AAS)诱导的肝毒性通常发生在运动人群以临床推荐剂量滥用C-17烷基化口服制剂时。注射用化合物似乎具有相同的肝毒性风险,但使用剂量比临床推荐剂量高3至6倍。AAS使用者偶尔会尝试通过使用药剂化合物N(一种磷脂/维生素制剂)来避免与滥用多种AAS药物相关的众所周知的肝毒性作用。

主要目的

研究化合物N对AAS诱导的毒性的实际肝保护作用。

方法

这是一项对320名运动员的观察性队列研究;160名是AAS使用者,另外160名未滥用任何物质。在160名使用者中,44名同时使用AAS和化合物N(A组),116名仅使用AAS(B组)。160名不滥用物质的运动员作为对照组(C组)。所有运动员均接受血清肝酶水平变化检测。比较三组在研究开始前和8周AAS用药方案结束后的酶水平,以确定化合物N的肝保护作用。

结果

在我们的研究之前,除肌酸激酶(CK)外,所有组的所有酶值均显示正常。8周后,A组的CK水平略低,但B组和C组无变化;谷氨酰转移酶(GT)水平保持正常。A组和C组除CK外,任何酶均无升高,而B组所有酶值均高于正常范围。将A组的AAS使用者与B组区分开来的唯一因素是使用了化合物N,因此结果表明该化合物具有解毒作用。除GT和CK外,AAS滥用的严重程度与所有测量酶的变化程度(值)呈正相关。

结论

我们的结果与之前关于运动性AAS滥用者血清肝酶升高与肌肉纤维损伤而非滥用本身有关的观点相矛盾。由于所有滥用AAS的运动员都容易出现酶值升高,A组的平均值应与B组观察到的平均值相似,超过正常值。B组的组肝酶值显著高于C组(对照组)。值得注意的是,与C组相比,A组的肝酶值没有任何统计学上的显著差异。训练方案的可比性排除了运动对这些酶升高的影响,并且AAS毒性与AAS滥用的严重程度相关。

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