Damgaard Ann, Højfeldt Grith, Thorsgaard Olivia, Bulut Yeliz, Linden Frederik Hvid, Schjerling Peter, Mackey Abigail L, Kistorp Caroline, Magnusson S Peter, Kjær Michael, Svensson Rene B
Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark.
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Am J Sports Med. 2025 Jul;53(8):1978-1987. doi: 10.1177/03635465251340701. Epub 2025 May 23.
Anabolic-androgenic steroids (AASs) are synthetic derivatives of testosterone that are abused by athletes to enhance their physical appearance and performance. AAS abusers have an increased risk of tendon ruptures compared with nonusers, and it has been proposed that AASs damage tendon tissue. Only a few human studies have investigated the effect of AASs on tendon tissue, and to our knowledge, there are no data on female sex.
PURPOSE/HYPOTHESIS: The purpose was to investigate the effect of current and former abuse of AASs on the patellar tendon (PT). It was hypothesized that AASs would not affect tendon tissue.
Cross-sectional study; Level of evidence, 3.
This study included recreational athletes with current (female: n = 4; male: n = 18; total: n = 22) or former (female: n = 5; male: n = 7; total: n = 12) AAS abuse and nonusers (female: n = 5; male: n = 9; total: n = 14). The authors investigated the proportion of tendon injuries, PT cross-sectional area by magnetic resonance imaging, mechanical properties by ultrasound, gene expression levels of connective tissue proteins, and cell density by histological staining from tendon biopsy samples.
The combined AAS group (both current and former abusers) reported a higher proportion of upper body tendon injuries compared with nonusers (79.4% vs 28.6%, respectively; = .002). There was no difference in PT cross-sectional area ( = .918) or cell density (fascicular matrix: = .413; interfascicular matrix: = .982) between current AAS abusers, former AAS abusers, and nonusers. There was a greater expression of IGF-1 mRNA in current AAS abusers compared with nonusers ( = .043), but there were no group differences in other mRNA targets. Former AAS abusers had significantly higher tendon deformation ( = .030) and strain ( = .026) at common force compared with nonusers. There were no significant differences between male and female participants in the effect of AASs on tendon tissue.
These data show that the PT itself was not severely affected by AAS abuse.
合成代谢雄激素类固醇（AAS）是睾酮的合成衍生物，被运动员滥用以改善其外形和提高成绩。与未使用者相比，AAS滥用者肌腱断裂的风险增加，有人提出AAS会损害肌腱组织。仅有少数人体研究调查了AAS对肌腱组织的影响，据我们所知，尚无关于女性的数据。
目的/假设：目的是研究当前和既往滥用AAS对髌腱（PT）的影响。假设AAS不会影响肌腱组织。
横断面研究；证据等级，3级。
本研究纳入了当前（女性：n = 4；男性：n = 18；总计：n = 22）或既往（女性：n = 5；男性：n = 7；总计：n = 12）滥用AAS的休闲运动员以及未使用者（女性：n = 5；男性：n = 9；总计：n = 14）。作者调查了肌腱损伤的比例、通过磁共振成像测量的PT横截面积、通过超声测量的力学性能、肌腱活检样本中结缔组织蛋白的基因表达水平以及通过组织学染色测量的细胞密度。
与未使用者相比，AAS联合组（当前和既往滥用者）报告的上身肌腱损伤比例更高（分别为79.4%和28.6%；P = .002）。当前AAS滥用者、既往AAS滥用者和未使用者之间的PT横截面积（P = .918）或细胞密度（束状基质：P = .413；束间基质：P = .982）没有差异。与未使用者相比，当前AAS滥用者中IGF-1 mRNA的表达更高（P = .043），但在其他mRNA靶点上没有组间差异。与未使用者相比，既往AAS滥用者在相同力作用下的肌腱变形（P = .030）和应变（P = .026）显著更高。AAS对肌腱组织的影响在男性和女性参与者之间没有显著差异。
这些数据表明，PT本身并未受到AAS滥用的严重影响。
