Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK.
Sports Med. 2012 Feb 1;42(2):119-34. doi: 10.2165/11598060-000000000-00000.
Recent reports from needle exchange programmes and other public health initiatives have suggested growing use of anabolic steroids (AS) in the UK and other countries. Data indicate that AS use is not confined to body-builders or high-level sportsmen. Use has spread to professionals working in emergency services, casual fitness enthusiasts and subelite sportsmen and women. Although the precise health consequences of AS use is largely undefined, AS use represents a growing public health concern. Data regarding the consequences of AS use on cardiovascular health are limited to case studies and a modest number of small cohort studies. Numerous case studies have linked AS use with a variety of cardiovascular disease (CVD) events or endpoints, including myocardial infarction, stroke and death. Large-scale epidemiological studies to support these links are absent. Consequently, the impact of AS use upon known CVD risk factors has been studied in relatively small, case-series studies. Data relating AS use to elevated blood pressure, altered lipid profiles and ECG abnormalities have been reported, but are often limited in scope, and other studies have often produced equivocal outcomes. The use of AS has been linked to the appearance of concentric left ventricular hypertrophy as well as endothelial dysfunction but the data again remains controversial. The mechanisms responsible for the negative effect of AS on cardiovascular health are poorly understood, especially in humans. Possibilities include direct effects on myocytes and endothelial cells, reduced intracellular Ca2+ levels, increased release of apoptogenic factors, as well as increased collagen crosslinks between myocytes. New data relating AS use to cardiovascular health risks are emerging, as novel technologies are developed (especially in non-invasive imaging) that can assess physiological structure and function. Continued efforts to fully document the cardiovascular health consequences of AS use is important to provide a clear, accurate, public health message to the many groups now using AS for performance and image enhancement.
最近来自针具交换计划和其他公共卫生措施的报告表明，在英国和其他国家，合成代谢类固醇（AS）的使用呈上升趋势。数据表明，AS 的使用并不仅限于健美运动员或高水平运动员。它已经蔓延到从事紧急服务、休闲健身爱好者以及低级别运动员的专业人士中。虽然 AS 使用的确切健康后果在很大程度上还没有定义，但 AS 的使用代表了一个日益严重的公共卫生问题。关于 AS 使用对心血管健康的后果的数据仅限于病例研究和少数小型队列研究。许多病例研究将 AS 使用与各种心血管疾病（CVD）事件或终点联系起来，包括心肌梗死、中风和死亡。缺乏支持这些联系的大规模流行病学研究。因此，AS 使用对已知 CVD 风险因素的影响在相对较小的病例系列研究中进行了研究。据报道，AS 使用与血压升高、脂质谱改变和心电图异常有关，但数据通常范围有限，其他研究结果往往模棱两可。AS 使用与左心室向心性肥厚和内皮功能障碍的出现有关，但数据仍然存在争议。AS 对心血管健康的负面影响的机制尚未得到很好的理解，特别是在人类中。可能性包括对心肌细胞和内皮细胞的直接影响、细胞内 Ca2+水平降低、促凋亡因子释放增加以及心肌细胞之间的胶原交联增加。随着新技术（特别是在非侵入性成像方面）的发展，新的数据不断涌现，这些新技术可以评估生理结构和功能，与 AS 使用对心血管健康风险的关系。继续努力全面记录 AS 使用对心血管健康的后果对于向现在为提高表现和形象而使用 AS 的许多群体提供明确、准确的公共卫生信息非常重要。
