Dickerman R D, McConathy W J, Zachariah N Y
Department of Biomedical Sciences, University of North Texas Health Science Center, Fort Worth 76107-2699, USA.
J Cardiovasc Risk. 1997 Oct-Dec;4(5-6):363-6.
That men have a higher risk of coronary heart disease has implicated testosterone as a risk factor. Lipoprotein levels have been reported to be altered by androgens, thus increasing the risk of coronary heart disease, myocardial infarction, and sudden death. The increasing abuse of anabolic steroids and reports of cases of sudden death and myocardial infarction among bodybuilders have raised concerns about an increase in cardiovascular risk for this population.
Twelve competitive bodybuilders were recruited for a comprehensive study on the cardiovascular risks associated with use of anabolic steroids. Six competitive heavyweight bodybuilders ingesting self-directed regimens of anabolic steroids (steroid group) and six competitive heavyweight drug-free bodybuilders were used for cardiovascular risk assessment. Apolipoproteins A-I and B, total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglyceride, testosterone, and sex hormone-binding globulin levels were determined in each athlete.
Total, HDL and LDL cholesterol, apolipoproteins A-I and B, and triglyceride levels were significantly lower in members of the steroid group. As expected, testosterone level was significantly higher in members of the steroid group; sex hormone-binding globulin level was significantly lower. Apolipoprotein and lipoprotein levels were lower in members of the steroid group, whereas the total: HDL cholesterol ratio was significantly higher for members of the steroid group.
Consistently with previous reports, androgens were associated with decreases in HDL cholesterol and apolipoprotein A-I levels. However, androgens were also associated with reduced LDL cholesterol and apolipoprotein B levels. Despite the significantly higher total: HDL cholesterol ratio, the low serum total cholesterol levels (within the fifth percentile) and low plasma triglyceride levels in members of the steroid group raise questions concerning the exact role of androgens in increasing risk of cardiovascular disease.
男性患冠心病的风险较高，这表明睾酮是一个风险因素。据报道，雄激素会改变脂蛋白水平，从而增加患冠心病、心肌梗死和猝死的风险。合成代谢类固醇的滥用日益增加，以及健美运动员中猝死和心肌梗死病例的报道，引发了人们对该人群心血管风险增加的担忧。
招募了12名竞技健美运动员，对使用合成代谢类固醇相关的心血管风险进行全面研究。选取6名自行服用合成代谢类固醇的竞技重量级健美运动员（类固醇组）和6名不使用药物的竞技重量级健美运动员进行心血管风险评估。测定了每位运动员的载脂蛋白A-I和B、总胆固醇、高密度脂蛋白（HDL）胆固醇、低密度脂蛋白（LDL）胆固醇、甘油三酯、睾酮和性激素结合球蛋白水平。
类固醇组运动员的总胆固醇、HDL和LDL胆固醇、载脂蛋白A-I和B以及甘油三酯水平显著较低。正如预期的那样，类固醇组运动员的睾酮水平显著较高；性激素结合球蛋白水平显著较低。类固醇组运动员的载脂蛋白和脂蛋白水平较低，而类固醇组运动员的总胆固醇与HDL胆固醇之比显著较高。
与先前的报道一致，雄激素与HDL胆固醇和载脂蛋白A-I水平降低有关。然而，雄激素也与LDL胆固醇和载脂蛋白B水平降低有关。尽管类固醇组运动员的总胆固醇与HDL胆固醇之比显著较高，但该组运动员较低的血清总胆固醇水平（处于第五百分位数以内）和较低的血浆甘油三酯水平，引发了关于雄激素在增加心血管疾病风险中的确切作用的疑问。
