Thompson P D, Cullinane E M, Sady S P, Chenevert C, Saritelli A L, Sady M A, Herbert P N
Department of Medicine, Miriam Hospital, Providence, RI 02906.
JAMA. 1989 Feb 24;261(8):1165-8.
Oral anabolic steroids produce striking reductions in serum concentrations of high-density lipoprotein (HDL) cholesterol. We hypothesized that this effect related to their route of administration and was unrelated to their androgenic potency. We administered oral stanozolol (6 mg/d) or supraphysiological doses of intramuscular testosterone enanthate (200 mg/wk) to 11 male weight lifters for six weeks in a crossover design. Stanozolol reduced HDL-cholesterol and the HDL2 subfraction by 33% and 71%, respectively. In contrast, testosterone decreased HDL-cholesterol concentration by only 9% and the decrease was in the HDL3 subfraction. Apolipoprotein A-I level decreased 40% during stanozolol but only 8% during testosterone treatment. The low-density lipoprotein cholesterol concentration increased 29% with stanozolol and decreased 16% with testosterone treatment. Stanozolol, moreover, increased postheparin hepatic triglyceride lipase activity by 123%, whereas the maximum change during testosterone therapy (+25%) was not significant. Weight gain was similar with both drugs, but testosterone was more effective in suppressing gonadotropic hormones. We conclude that the undesirable lipoprotein effects of 17-alpha-alkylated steroids given orally are different from those of parenteral testosterone and that the latter may be preferable in many clinical situations.
口服合成代谢类固醇可使血清高密度脂蛋白（HDL）胆固醇浓度显著降低。我们推测这种作用与其给药途径有关，而与它们的雄激素效力无关。我们采用交叉设计，对11名男性举重运动员给予口服司坦唑醇（6毫克/天）或超生理剂量的肌肉注射庚酸睾酮（200毫克/周），为期六周。司坦唑醇分别使HDL胆固醇和HDL2亚组分降低了33%和71%。相比之下，睾酮仅使HDL胆固醇浓度降低了9%，且降低的是HDL3亚组分。载脂蛋白A-I水平在司坦唑醇治疗期间降低了40%，而在睾酮治疗期间仅降低了8%。低密度脂蛋白胆固醇浓度在司坦唑醇治疗时升高了29%，而在睾酮治疗时降低了16%。此外，司坦唑醇使肝素后肝甘油三酯脂肪酶活性增加了123%，而睾酮治疗期间的最大变化（+25%）不显著。两种药物的体重增加相似，但睾酮在抑制促性腺激素方面更有效。我们得出结论，口服17-α-烷基化类固醇产生的不良脂蛋白效应与胃肠外给予睾酮的效应不同，在许多临床情况下，后者可能更可取。
