Outpatient AAS clinic, Department of Internal Medicine, Elisabeth-TweeSteden Hospital, Tilburg.
PeterBond.org, Zeist.
Curr Opin Endocrinol Diabetes Obes. 2022 Dec 1;29(6):560-565. doi: 10.1097/MED.0000000000000759. Epub 2022 Aug 4.
Data on the health effects of androgen abuse are mainly derived from lower level evidence, such as case series and cross-sectional studies. In the last few years a relatively large and prospective cohort initiative, the HAARLEM (health risks of anabolic androgenic steroid use by male amateur athletes) study, made an important contribution to current knowledge.
The HAARLEM study showed that all androgen abusers experience positive and negative effects, such as an increase in strength and acne and gynecomastia, respectively. Effects are generally reversible and acute life-threatening toxicity is rare. There is a distinct but limited impact on liver and kidney function. Gonadal function is disrupted but resumes normally after abuse is discontinued in the majority of athletes. The negative impact of androgens on cardiovascular parameters, such as blood pressure, hematocrit and lipid metabolism, as well as cardiac structure and function, seems to be the mechanism for premature atherosclerosis and cardiomyopathy, respectively, in long-term users.
It is beyond dispute that androgen abuse is harmful and much of the short-term toxicity is well documented. To prevent the long-term health hazards, there should be ample focus on preventive measures, both primary and secondary, and effective harm reduction strategies should be developed.
雄激素滥用对健康影响的数据主要来源于低水平的证据，如病例系列和横断面研究。在过去的几年中，一个相对较大的前瞻性队列倡议——哈勒姆（男性业余运动员使用合成代谢雄激素类固醇的健康风险）研究，对当前的知识做出了重要贡献。
哈勒姆研究表明，所有雄激素滥用者都经历了积极和消极的影响，例如力量的增加和痤疮和男性乳房发育。这些影响通常是可逆的，急性危及生命的毒性很少见。雄激素对肝肾功能的影响是明显的，但有限。在大多数运动员停止滥用后，性腺功能会受到干扰，但会恢复正常。雄激素对心血管参数的负面影响，如血压、血细胞比容和脂质代谢，以及心脏结构和功能，似乎是导致长期使用者过早发生动脉粥样硬化和心肌病的机制。
雄激素滥用有害是无可争议的，其大部分短期毒性都有充分的记录。为了预防长期的健康危害，应该充分关注预防措施，包括初级和二级预防，同时制定有效的减少危害策略。
