Programa de Pós-Graduação em Medicina e Saúde (PPgMS), Faculdade de Medicina da Bahia, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.
Liver Int. 2011 Mar;31(3):348-53. doi: 10.1111/j.1478-3231.2010.02346.x. Epub 2010 Oct 11.
Industrial toxin and drugs have been associated with non-alcoholic fatty liver disease (NAFLD); in these cases, the disease has been termed toxicant-associated steatohepatitis (TASH).
This study hypothesizes that the use of anabolic-androgenic steroids (AAS) could also be a risk factor to TASH or better toxicant-associated fatty liver disease (TAFLD) development.
Case-control study including 180 non-competitive recreational male bodybuilders from August/2007 to March/2009. Ninety-five had a history of intramuscular AAS use (cases; G1) and 85 were non-users (controls; G2). They underwent a clinical evaluation and abdominal ultrasound, and their blood levels of aminotransferases, creatine phosphokinase (CPK), lipids, glucose and insulin were measured. TAFLD criteria: history of AAS use >2 years; presence of hepatic steatosis on ultrasound and/or aminotransferase alterations with normal CPK levels; exclusion of ethanol intake ≥20 g/day or use of other drugs; and exclusion of obesity, dyslipidaemia, diabetes and other liver diseases. Homeostasis model assessment for insulin resistance ≥3 was considered insulin resistant. Independent t-test, odds ratio (OR) and 95% confidence intervals (95% CI) were calculated.
All cases were asymptomatic. Clinical and laboratorial data were similar in G1 and G2 (P>0.05). TAFLD criteria were observed in 12.6% of the G1 cases and 2.4% of controls had criteria compliant with non-alcoholic fatty liver related to metabolic conditions. OR was 6.0 (95% CI: 1.3-27.6).
These results suggest that AAS could be a possible new risk factor for TAFLD. In this type of fatty liver disease, the individuals had a low body fat mass and they did not present insulin resistance.
工业毒素和药物与非酒精性脂肪性肝病（NAFLD）有关；在这些情况下，该疾病被称为毒物相关性脂肪性肝炎（TASH）。
本研究假设使用合成代谢雄激素类固醇（AAS）也可能是 TASH 或更好的毒物相关性脂肪性肝病（TAFLD）发展的一个危险因素。
包括 2007 年 8 月至 2009 年 3 月间 180 名非竞技性业余男性健美运动员的病例对照研究。95 名运动员有肌肉内 AAS 使用史（病例组；G1），85 名运动员为非使用者（对照组；G2）。他们接受了临床评估和腹部超声检查，并测量了他们的转氨酶、肌酸磷酸激酶（CPK）、血脂、血糖和胰岛素水平。TAFLD 标准：AAS 使用史>2 年；超声存在肝脂肪变性和/或转氨酶改变，CPK 水平正常；排除乙醇摄入量≥20 g/天或使用其他药物；排除肥胖、血脂异常、糖尿病和其他肝病。稳态模型评估的胰岛素抵抗指数≥3 被认为是胰岛素抵抗。计算了独立样本 t 检验、比值比（OR）和 95%置信区间（95%CI）。
所有病例均无症状。G1 和 G2 之间的临床和实验室数据相似（P>0.05）。G1 组中有 12.6%的病例符合 TASH 标准，而对照组中有 2.4%的病例符合与代谢条件相关的非酒精性脂肪肝标准。OR 为 6.0（95%CI：1.3-27.6）。
这些结果表明 AAS 可能是 TAFLD 的一个新的可能危险因素。在这种类型的脂肪肝疾病中，个体的体脂肪质量较低，且不存在胰岛素抵抗。
