Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Stockholm, Sweden.
Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences (GIH), Stockholm, Sweden.
Drug Test Anal. 2023 Jul;15(7):769-778. doi: 10.1002/dta.3479. Epub 2023 Apr 18.
The steroid module of the athlete biological passport (ABP) aims to detect doping with endogenous steroids by longitudinally monitoring epitestosterone (E), testosterone (T), and four metabolically related steroids and their ratios. There are large variations in the urinary levels of the androgen metabolites due to genetic polymorphisms, drug use, menstrual cycle, and other factors. In this study, we aimed to increase our understanding of the natural, within-individual variations of the established ABP markers in males and females over time, looking at samples collected both in and out-of-competition (IC/OOC). Urinary steroid profiles from 323 Swedish athletes, with at least five samples per athlete, were extracted from ADAMS together with information on type of sport, IC/OOC, and time of day. Data were analyzed using coefficient of variation (CV%) to examine within-subject variability and linear mixed effects models to estimate within-subject change in the metabolites over time. The metabolites and ratios expressed higher individual CV% in females (23-56) than in males (18-39). Samples taken OOC showed larger intra-individual variations than samples collected IC for most of the ABP metabolites in both sexes. The median concentrations were higher IC for some metabolites, particularly testosterone being 52% higher among females. Time of day influenced the intra-individual variation of the urinary steroid profile with decreases in androgen metabolites over time, if measured in evening versus daytime. These findings can aid in the testing strategies and interpretation of the steroidal module of ABP.
运动员生物护照（ABP）的类固醇模块旨在通过纵向监测表雄酮（E）、睾酮（T）和四种代谢相关的类固醇及其比值来检测内源性类固醇的兴奋剂。由于遗传多态性、药物使用、月经周期和其他因素，雄激素代谢物的尿液水平存在很大差异。在这项研究中，我们旨在通过分析同时在比赛内（IC）和比赛外（OOC）收集的样本，增加对男性和女性中既定 ABP 标记物随时间的自然个体内变化的理解。从 ADAMS 中提取了 323 名瑞典运动员的尿液类固醇谱，每个运动员至少有五个样本，并附有关于运动类型、IC/OOC 和一天中的时间的信息。使用变异系数（CV%）分析数据，以检查个体内变异性，并使用线性混合效应模型估计随时间变化的代谢物的个体内变化。在女性（23-56）中，代谢物和比值的个体内 CV% 高于男性（18-39）。对于大多数 ABP 代谢物，OOC 采集的样本比 IC 采集的样本个体内变化更大。在女性中，一些代谢物的中位数浓度在 IC 更高，尤其是睾酮高 52%。如果在晚上和白天测量，时间会影响尿液类固醇谱的个体内变化，雄激素代谢物随时间减少。这些发现可以帮助制定测试策略和解释 ABP 的类固醇模块。
