Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, West Switzerland, Epalinges, Switzerland.
Endocrinol Metab Clin North Am. 2010 Mar;39(1):59-73, viii-ix. doi: 10.1016/j.ecl.2009.11.003.
The Athlete Biological Passport (ABP) is an individual electronic document that collects data regarding a specific athlete that is useful in differentiating between natural physiologic variations of selected biomarkers and deviations caused by artificial manipulations. A subsidiary of the endocrine module of the ABP, that which here is called Athlete Steroidal Passport (ASP), collects data on markers of an altered metabolism of endogenous steroidal hormones measured in urine samples. The ASP aims to identify not only doping with anabolic-androgenic steroids, but also most indirect steroid doping strategies such as doping with estrogen receptor antagonists and aromatase inhibitors. Development of specific markers of steroid doping, use of the athlete's previous measurements to define individual limits, with the athlete becoming his or her own reference, the inclusion of heterogeneous factors such as the UDPglucuronosyltransferase B17 genotype of the athlete, the knowledge of potentially confounding effects such as heavy alcohol consumption, the development of an external quality control system to control analytical uncertainty, and finally the use of Bayesian inferential methods to evaluate the value of indirect evidence have made the ASP a valuable alternative to deter steroid doping in elite sports. The ASP can be used to target athletes for gas chromatography/combustion/ isotope ratio mass spectrometry (GC/C/IRMS) testing, to withdraw temporarily the athlete from competing when an abnormality has been detected, and ultimately to lead to an antidoping infraction if that abnormality cannot be explained by a medical condition. Although the ASP has been developed primarily to ensure fairness in elite sports, its application in endocrinology for clinical purposes is straightforward in an evidence-based medicine paradigm.
运动员生物护照（ABP）是一种个人电子文档，它收集了有关特定运动员的数据，这些数据有助于区分选定生物标志物的自然生理变化与人为操纵引起的偏差。ABP 的内分泌模块的一个分支，即本文所称的运动员类固醇护照（ASP），收集了尿液样本中内源性类固醇激素代谢改变的标志物数据。ASP 的目的不仅是识别使用合成代谢雄激素类固醇的兴奋剂，还识别大多数间接类固醇兴奋剂策略，如使用雌激素受体拮抗剂和芳香酶抑制剂的兴奋剂。开发特定的类固醇兴奋剂标志物、使用运动员以前的测量值来定义个体极限，使运动员成为自己的参考、纳入运动员 UDP-葡萄糖醛酸转移酶 B17 基因型等异质因素、了解潜在的混杂影响，如大量饮酒、开发外部质量控制系统以控制分析不确定性，最后使用贝叶斯推理方法评估间接证据的价值，这些都使 ASP 成为阻止精英运动中类固醇兴奋剂的有价值的替代方法。ASP 可用于针对气相色谱/燃烧/同位素比质谱（GC/C/IRMS）测试的运动员，当检测到异常时暂时将运动员从比赛中撤出，如果不能用医疗条件来解释这种异常，则最终会导致反兴奋剂违规。尽管 ASP 主要是为了确保精英运动中的公平性而开发的，但在基于证据的医学范式中，其在临床内分泌学中的应用是直接的。
