Seara Fernando A C, Olivares Emerson L, Nascimento Jose H M
Laboratory of Cardiovascular Physiology and Pharmacology, Department of Physiological Sciences, Federal Rural University of Rio de Janeiro, Seropédica, RJ, Brazil; Multicenter Graduate Program in Physiological Sciences, Department of Physiological Sciences, Institute of Biological and Health Sciences, Federal Rural University of Rio de Janeiro, Seropédica, Brazil; Laboratory of Cardiac Electrophysiology, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Laboratory of Cardiovascular Physiology and Pharmacology, Department of Physiological Sciences, Federal Rural University of Rio de Janeiro, Seropédica, RJ, Brazil; Multicenter Graduate Program in Physiological Sciences, Department of Physiological Sciences, Institute of Biological and Health Sciences, Federal Rural University of Rio de Janeiro, Seropédica, Brazil.
Steroids. 2020 Sep;161:108660. doi: 10.1016/j.steroids.2020.108660. Epub 2020 May 31.
Anabolic steroids (AS) are synthetic testosterone-derivatives developed by the pharmaceutical industry to mimic testosterone biological effects. So far, AS have been implicated in the treatment of pathological conditions, such as hypogonadism, anemia, and cachexia. Since their discovery, though, AS have been illicitly used by elite and recreational athletes, bodybuilders and weightlifters in order to enhance athletic and aesthetic performance. This practice is characterized by cycles of administration and withdrawal, the combination of different AS compounds, and administration of doses 50 - 1000 times higher than those recommended for therapeutic purposes. AS excess has been correlated to cardiovascular detrimental effects, including cardiac hypertrophy, arrhythmias, and hypertension. Particularly, acute myocardial infarction (AMI) has been extensively reported by clinical and post-mortem studies. Atherosclerosis, hypercoagulability state, increased thrombogenesis and vasospasm have arisen as potential causes of myocardial ischemia in AS users. Additionally, several experimental reports have demonstrated that AS can increase the susceptibility to cardiac ischemia/reperfusion injury, whereas the cardioprotection elicited by physical exercise and ischemic postconditioning is blunted. Altogether, these factors can contribute to increased AMI morbidity and mortality during AS excess, particularly when AS are combined with other compounds, such as thyroid hormones, growth hormones, insulin, and diuretics.
合成代谢类固醇（AS）是制药行业研发的睾酮衍生物，用于模拟睾酮的生物学效应。到目前为止，AS已被用于治疗性腺功能减退、贫血和恶病质等病理状况。然而，自发现以来，AS一直被精英运动员、业余运动员、健美运动员和举重运动员非法使用，以提高运动成绩和审美效果。这种做法的特点是用药和停药周期、不同AS化合物的组合以及使用剂量比治疗目的推荐剂量高50至1000倍。AS过量与心血管有害影响相关，包括心脏肥大、心律失常和高血压。特别是，临床和尸检研究广泛报道了急性心肌梗死（AMI）。动脉粥样硬化、高凝状态、血栓形成增加和血管痉挛已成为AS使用者心肌缺血的潜在原因。此外，一些实验报告表明，AS可增加心脏缺血/再灌注损伤的易感性，而体育锻炼和缺血后处理所引发的心脏保护作用则减弱。总之，这些因素可导致AS过量时AMI发病率和死亡率增加，尤其是当AS与甲状腺激素、生长激素、胰岛素和利尿剂等其他化合物合用时。
