Andrews Mary A, Magee Charles D, Combest Travis M, Allard Rhonda J, Douglas Kevin M
Uniformed Services University of the Health Sciences, Bethesda, MD.
Walter Reed National Military Medical Center, Bethesda, MD.
Curr Sports Med Rep. 2018 Jul;17(7):232-241. doi: 10.1249/JSR.0000000000000500.
Many athletes use anabolic-androgenic steroids (AAS) for physical enhancement but the magnitude of these gains and associated adverse effects has not been rigorously quantified. MEDLINE, EMBASE, Cochrane, SPORTDiscus, and PsycINFO were searched to identify randomized placebo-controlled trials of AAS in healthy exercising adults that reported one of the following outcomes: muscular strength, body composition, cardiovascular endurance, or power. Two authors appraised abstracts to identify studies for full-text retrieval; these were reviewed in duplicate to identify included studies. Study quality was assessed using the Cochrane method. Data were extracted in duplicate and pooled using the DerSimonian and Laird random effects model and to calculate the ratio of mean outcome improvement where possible. Pooled standardized mean difference (SMD) in muscle strength between AAS and placebo was 0.27 (95% confidence interval, 0.07-0.47; I = 12.7%; 21 studies). Change in strength was 52% greater in the AAS group compared to placebo. The SMD for change in lean mass between AAS and placebo was 0.62 (95% confidence interval, 0.35-0.89; I = 26%; 14 studies). Due to missing data, fat mass, cardiovascular endurance, power, and adverse effects were summarized qualitatively. Only 13 of 25 studies reported adverse effects including increased low density lipoprotein (LDL), decreased high density lipoprotein (HDL), irritability, and acne. In healthy exercising adults, AAS use is associated with a small absolute increase in muscle strength and moderate increase in lean mass. However, the transparency and completeness of adverse effect reporting varied, most studies were of short duration, and doses studied may not reflect actual use by athletes.
许多运动员使用合成代谢雄激素类固醇（AAS）来增强体能，但这些体能提升的幅度以及相关的不良影响尚未得到严格量化。检索了MEDLINE、EMBASE、Cochrane、SPORTDiscus和PsycINFO数据库，以确定在健康的运动成年人中进行的AAS随机安慰剂对照试验，这些试验报告了以下结果之一：肌肉力量、身体成分、心血管耐力或功率。两位作者评估摘要以确定进行全文检索的研究；对这些研究进行了重复审查以确定纳入的研究。使用Cochrane方法评估研究质量。数据进行了重复提取，并使用DerSimonian和Laird随机效应模型进行合并，以便在可能的情况下计算平均结果改善的比率。AAS组与安慰剂组之间肌肉力量的合并标准化平均差（SMD）为0.27（95%置信区间，0.07 - 0.47；I² = 12.7%；21项研究）。与安慰剂组相比，AAS组的力量变化大52%。AAS组与安慰剂组之间瘦体重变化的SMD为0.62（95%置信区间，0.35 - 0.89；I² = 26%；14项研究）。由于数据缺失，对脂肪量、心血管耐力、功率和不良影响进行了定性总结。25项研究中只有13项报告了不良影响，包括低密度脂蛋白（LDL）升高、高密度脂蛋白（HDL）降低、易怒和痤疮。在健康的运动成年人中，使用AAS与肌肉力量的小幅绝对增加和瘦体重的适度增加有关。然而，不良影响报告的透明度和完整性各不相同，大多数研究持续时间较短，且所研究的剂量可能无法反映运动员实际使用的情况。
