Roşca Adrian Eugen, Vlădăreanu Ana-Maria, Mititelu Alina, Popescu Bogdan Ovidiu, Badiu Corin, Căruntu Constantin, Voiculescu Suzana Elena, Onisâi Minodora, Gologan Şerban, Mirica Radu, Zăgrean Leon
Division of Physiology and Neuroscience, Department of Functional Sciences, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Victor Babeş National Institute of Research-Development in the Pathology Domain, 050096 Bucharest, Romania.
J Clin Med. 2021 Jan 4;10(1):147. doi: 10.3390/jcm10010147.
Anabolic androgenic steroids (AAS), simply called "androgens", represent the most widespread drugs used to enhance performance and appearance in a sporting environment. High-dosage and/or long-term AAS administration has been associated frequently with significant alterations in the cardiovascular system, some of these with severe endpoints. The induction of a prothrombotic state is probably the most life-threatening consequence, suggested by numerous case reports in AAS-abusing athletes, and by a considerable number of human and animal studies assessing the influence of exogenous androgens on hemostasis. Despite over fifty years of research, data regarding the thrombogenic potential of exogenous androgens are still scarce. The main reason is the limited possibility of conducting human prospective studies. However, human observational studies conducted in athletes or patients, in vitro human studies, and animal experiments have pointed out that androgens in supraphysiological doses induce enhanced platelet activity and thrombopoiesis, leading to increased platelet aggregation. If this tendency overlaps previously existing coagulation and/or fibrinolysis dysfunctions, it may lead to a thrombotic diathesis, which could explain the multitude of thromboembolic events reported in the AAS-abusing population. The influence of androgen excess on the platelet activity and fluid-coagulant balance remains a subject of debate, urging for supplementary studies in order to clarify the effects on hemostasis, and to provide new compelling evidence for their claimed thrombogenic potential.
合成代谢雄激素类固醇（AAS），简称为“雄激素”，是体育环境中用于提高成绩和改善外观的最普遍使用的药物。高剂量和/或长期使用AAS常常与心血管系统的显著改变有关，其中一些改变会导致严重后果。促血栓形成状态的诱导可能是最危及生命的后果，这在滥用AAS的运动员的大量病例报告以及许多评估外源性雄激素对止血影响的人体和动物研究中都有所体现。尽管经过了五十多年的研究，但关于外源性雄激素血栓形成潜力的数据仍然稀缺。主要原因是进行人类前瞻性研究的可能性有限。然而，在运动员或患者中进行的人体观察性研究、体外人体研究以及动物实验都指出，超生理剂量的雄激素会增强血小板活性和血小板生成，导致血小板聚集增加。如果这种趋势与先前存在的凝血和/或纤维蛋白溶解功能障碍重叠，可能会导致血栓形成倾向，这可以解释在滥用AAS人群中报告的大量血栓栓塞事件。雄激素过量对血小板活性和液体凝血平衡的影响仍然是一个有争议的话题，迫切需要进行补充研究，以阐明其对止血的影响，并为其声称的血栓形成潜力提供新的有力证据。
