Niedfeldt Mark W
Medical College of Wisconsin Private Practice, Mequon, WI.
Curr Sports Med Rep. 2018 Mar;17(3):97-102. doi: 10.1249/JSR.0000000000000467.
Anabolic steroids are synthetic derivatives of testosterone shown to increase muscle size and strength. Chemical substitutions on the testosterone molecule cause increased potency and duration of action. The 17-α-alkylation modification allows steroids to be taken orally, but the slower clearance in the liver makes them more hepatotoxic. The frequency and severity of side effects depends on several factors including the formulation of the drug, route of administration, dosage, duration of use, and individual sensitivity and response. Anabolic steroid users tend to take supraphysiologic doses or multiple steroids and other drugs simultaneously which increases risk of adverse effects. Hepatotoxicity can be seen as elevated liver transaminases, acute cholestatic syndrome, chronic vascular injury, hepatic tumors, and toxicant-associated fatty liver disease, as well as significant changes in lipoproteins. Many of these changes will stabilize or reverse with cessation of steroid use, but some can be life-threatening. Over-the-counter supplements can be contaminated with anabolic steroids, causing hepatotoxicity in unsuspecting consumers.
合成代谢类固醇是睾酮的合成衍生物，已证实可增加肌肉大小和力量。睾酮分子上的化学取代会导致效力增强和作用持续时间延长。17-α-烷基化修饰使类固醇能够口服，但在肝脏中的清除较慢使其肝毒性更强。副作用的频率和严重程度取决于几个因素，包括药物配方、给药途径、剂量、使用持续时间以及个体敏感性和反应。合成代谢类固醇使用者倾向于服用超生理剂量或同时服用多种类固醇及其他药物，这增加了不良反应的风险。肝毒性表现为肝转氨酶升高、急性胆汁淤积综合征、慢性血管损伤、肝肿瘤、毒物相关性脂肪性肝病以及脂蛋白的显著变化。这些变化中的许多在停止使用类固醇后会稳定或逆转，但有些可能危及生命。非处方补充剂可能被合成代谢类固醇污染，在毫无戒心的消费者中导致肝毒性。
