Schwingel Paulo Adriano, Cotrim Helma Pinchemel, Santos Crimério Ribeiro dos, Santos Adriano Oliveira dos, Andrade Antônio Ricardo Cardia Ferraz de, Carruego Marcos Vinicius Vilas Boas, Zoppi Cláudio Cesar
a Post-graduation Program in Medicine and Health , Universidade Federal da Bahia , Canela , Brazil.
b Departamento de Biologia Estrutural e Funcional , Universidade Estadual de Campinas , Campinas , Brazil.
Subst Use Misuse. 2015;50(11):1490-8. doi: 10.3109/10826084.2015.1018550. Epub 2015 Nov 7.
The recreational use of anabolic-androgenic steroids (AAS) has reached alarming levels among healthy people. However, several complications have been related to consumption of these drugs, including liver disorders.
To evaluate the prevalence of liver injuries in young Brazilian recreational AAS users.
Between February/2007 and May/2012 asymptomatic bodybuilders who were ≥18 years old and reported AAS use for ≥6 months were enrolled. All had clinical evaluations, abdominal ultrasound (AUS), and blood tests.
182 individuals were included in the study. The median age (interquartile range) was 26.0 years (22.0-30.0) and all were male. Elevated liver enzyme levels were observed in 38.5% (n = 70) of AAS users, and creatine phosphokinase was normal in 27.1% (n = 19) of them. Hepatic steatosis was observed by AUS in 12.1% of the sample. One individual had focal nodular hyperplasia and another had hepatocellular adenoma. One case each of hepatitis B and C virus infection was found. A diagnosis of toxic liver injury was suggested in 23 (12.6%) AAS users without a history of alcohol or other medications/drugs consumption, or evidence of other liver diseases.
CONCLUSIONS/IMPORTANCE: Young Brazilian recreational AAS users presented a wide spectrum of liver injuries that included hepatotoxicity, fatty liver, and liver neoplasm. They also presented risk factors for liver diseases such as alcohol consumption and hepatitis B and C virus infection. The results suggest that the risk of AAS use for the liver may be greater than the esthetic benefits, and demonstrate the importance of screening AAS users for liver injuries.
合成代谢雄激素类固醇（AAS）在健康人群中的非医疗使用已达到令人担忧的程度。然而，使用这些药物会引发多种并发症，包括肝脏疾病。
评估巴西年轻非医疗AAS使用者肝脏损伤的患病率。
纳入2007年2月至2012年5月期间年龄≥18岁、报告使用AAS≥6个月的无症状健美运动员。所有参与者均接受临床评估、腹部超声（AUS）检查和血液检测。
182人纳入研究。中位年龄（四分位间距）为26.0岁（22.0 - 30.0），均为男性。38.5%（n = 70）的AAS使用者肝酶水平升高，其中27.1%（n = 19）的人肌酸磷酸激酶正常。AUS检查发现12.1%的样本有肝脂肪变性。1人有局灶性结节性增生，另1人有肝细胞腺瘤。各发现1例乙型和丙型肝炎病毒感染。23名（12.6%）无酒精或其他药物/毒品使用史且无其他肝脏疾病证据的AAS使用者被诊断为药物性肝损伤。
结论/重要性：巴西年轻非医疗AAS使用者存在多种肝脏损伤，包括肝毒性、脂肪肝和肝脏肿瘤。他们还存在如饮酒以及乙型和丙型肝炎病毒感染等肝脏疾病风险因素。结果表明，使用AAS对肝脏造成的风险可能大于其带来的美观益处，并证明了筛查AAS使用者肝脏损伤的重要性。
