Anabolic Androgen Research Articles

Sleep pathology and use of anabolic androgen steroids among male weightlifters in Norway

Use of anabolic androgenic steroids (AAS) causes drastic changes in hormonal milieu and is associated with a range of medical and psychological consequences. Sleep pathology is a common side-effect of AAS use but few have studied these relations. This study examined the relationship between AAS use, psychological distress and sleep quality, and how phases of heavy use and abstinence influence sleep. The Pittsburgh-Sleep-Quality-Index (PSQI) and Jenkins Sleep Scale (JSS) were used to assess sleep quality, and psychological distress was measured with the Hopkins Symptoms Checklist (HSCL). Participants comprised men who have previous or current long-term use of AAS (n = 68) and non-using weightlifting controls (WLC) (n = 58), where a subgroup of participants (n = 22) was monitored over ~ 6 months during phases of AAS use and withdrawal. Group differences on PSQI and JSS were evaluated with Kruskal-Wallis H tests, and the mediating role of psychological distress was evaluated using structural equation modeling. Linear mixed models were used to assess the role of AAS use and withdrawal on sleep quality. Among the AAS group, 66% reported sleep problems as a side effect, and 38% had used sleep medication. PSQI scores showed significantly lower sleep quality in the AAS group compared to WLC (p < 0.001) on all subscales except “sleep latency”. Furthermore, sleep quality was significantly poorer during withdrawal-phases than periods with AAS use (p < .001). Our findings provide key insight into sleep disturbances among men who use AAS, suggesting a link between sleep disturbances and hormone levels that deviate from physiologically normal levels in both directions.

Low levels of endogenous anabolic androgenic steroids in females with severe asthma taking corticosteroids.

Patients with severe asthma are dependent upon treatment with high doses of inhaled corticosteroids (ICS) and often also oral corticosteroids (OCS). The extent of endogenous androgenic anabolic steroid (EAAS) suppression in asthma has not previously been described in detail. The objective of the present study was to measure urinary concentrations of EAAS in relation to exogenous corticosteroid exposure. Urine collected at baseline in the U-BIOPRED (Unbiased Biomarkers for the Prediction of Respiratory Disease outcomes) study of severe adult asthmatics (SA, n=408) was analysed by quantitative mass spectrometry. Data were compared to that of mild-to-moderate asthmatics (MMA, n=70) and healthy subjects (HC, n=98) from the same study. The concentrations of urinary endogenous steroid metabolites were substantially lower in SA than in MMA or HC. These differences were more pronounced in SA patients with detectable urinary OCS metabolites. Their dehydroepiandrosterone sulfate (DHEA-S) concentrations were <5% of those in HC, and cortisol concentrations were below the detection limit in 75% of females and 82% of males. The concentrations of EAAS in OCS-positive patients, as well as patients on high-dose ICS only, were more suppressed in females than males (p<0.05). Low levels of DHEA were associated with features of more severe disease and were more prevalent in females (p<0.05). The association between low EAAS and corticosteroid treatment was replicated in 289 of the SA patients at follow-up after 12-18 months. The pronounced suppression of endogenous anabolic androgens in females might contribute to sex differences regarding the prevalence of severe asthma.

Quantitation of Ecdysterone and Targeted Analysis of WADA-Prohibited Anabolic Androgen Steroids, Hormones, and Metabolic Modulators in Ecdysterone-Containing Dietary Supplements

The aim of our research was to perform a comprehensive study of ecdysterone (ECD)-containing dietary supplements (DSs). Two analytical methods were optimised according to the expected concentration of the target compounds: quantitation of ECD by liquid chromatography (LC) coupled to diode array detector (DAD), and limit test for 47 World Anti-Doping Agency prohibited by LC coupled with tandem mass spectrometer (MS/MS). For quantitation of ECD, the method was fully validated with outstanding performance characteristics (LOD: 35 µg·g−1, LOQ: 115 µg·g−1, CV% &lt; 5%), resulting in significantly lower LOD and shorter runtime than published previously. For limit tests, a chromatographic method was developed to obtain excellent separation, while MS/MS parameters were optimised to allow the lowest possible reporting limit (RL: 0.6–10 ng·g−1 or mL−1). Twenty-one ecdysterone-containing DSs from ten brands were analysed. In all cases, the measured ECD content was much lower than labelled, and 20% of the samples contained a prohibited substance. The concentration of ecdysterone and contaminations varied randomly from batch to batch. The developed methods help to prevent the use of contaminated or useless DSs.

A study to demonstrate the potential of Anabolic Androgen Steroid to activate oxidative tissue damage, nephrotoxicity and decline endogenous antioxidant system in renal tissue of Adult Wistar Rats.

Anabolic Androgenic steroids (AAS) are abused and reports have been made on their deleterious effects on various organs. It is imperative to report the mechanism of inducing oxidative tissue damage even in the presence of an intracellular antioxidant system by the interaction between lipid peroxidation and the antioxidant system in the kidney. Twenty (20) adult male Wistar rats used were grouped into: A- Control, BOlive oil vehicle, C- 120mg/kg of AAS orally for three weeks, and D- 7 days withdrawal group following 120mg/kg/ 21days of AAS intake. Serum was assayed for lipid peroxidation marker Malondialdehyde (MDA) and antioxidant enzyme -superoxide Dismutase (SOD). Sectioned of kidneys were stained to see the renal tissue, mucin granules, and basement membrane. AAS-induced oxidative tissue damage, in the presence of an endogenous antioxidant, is characterized by increased lipid peroxidation and decreased SOD level which resulted in the loss of renal tissue cells membrane integrity which is a characteristic of the pathophysiology of nephron toxicity induced by a toxic compound. However, this was progressively reversed by a period of discontinuation of AAS drug exposure.

Recreational Drugs and the Risk of Hepatocellular Carcinoma.

Recreational or aesthetic drug use is a distinctive behavior of humans, principally attested in the last century. It is known that recreational and illegal drugs are major contributors to the universal morbidity rate worldwide. Many of these substances have a well-established hepatotoxic potential, causing acute or chronic liver injury, liver fibrosis and cirrhosis, but their implications for hepatocellular carcinoma or other varieties of liver tumors are little known. In this article, we perform an extensive literature review, aiming to provide updated information about recreational drug use and the risk of developing liver tumors. Khat use and pyrrolizidine alkaloid consumption (present in some natural plants) have been linked to liver cirrhosis. Kava intake is associated with different liver tumors in animal models but not in humans. Cannabis' potential to accelerate liver fibrosis in chronic hepatitis is controversial according to the existing data. Cigarette smoking is an important contributor to hepatocellular carcinoma, and anabolic androgen steroids are well-defined causes of a variety of liver cancers and other hepatic tumors. Long-term follow-up studies of subjects who have developed injuries in association with the use of recreational drugs are warranted so as to better define the risk of developing hepatocellular carcinoma in association with these substances and, thus, to implement health care policies to combat this preventable cause of cancer.

Use of Oxandrolone as Adjunctive Therapy in Right Ischiotibial Injury

Androgen hormones serve a variety of roles, including determining and maintaining sexual traits. The effects of Anabolic Androgen Steroids (AAS) like oxandrolone on body composition and muscle mass development are intriguing. We provide a case of a 38-year-old woman who was treated with oxandrolone for multiple fractures and a current right ischiotibial injury, indicating that androgen steroid medication may aid in the recovery of bone and tendon-muscle health in injuries. The improvement in pain was significantly relevant, allowing the patient to return to her normal activities.

Study the Effect of the Anabolic Androgen Methandrostenolone on Some Physiological Parameters in Local Male Rabbits

This study amid to detect the effect of anabolic androgenic Methandrostenolone (Dianabol) on the level of liver enzymes, urea and creatinine in addition to its effect on the level of estrogen in local rabbit. In this experiment, we used (30) adult male rabbits, distributed randomly into three groups, each group 10 animals. Control group(C): Animals were dosed with distilled water only. First treatment group (T1):Animals were dosed orally with Methandrostenolone (Dianabol) within a dosing cycle that continued for (8) weeks in an ascending manner: (0.076, 0.152, 0.304, 0.38, 0.456, 0.532, 0.608, 0.684) mg/kg B.W/d. Second treatment group (T2): Animals were administered the same anabolic androgen orally within a course of doses that lasted for (8) weeks in a hierarchical manner:( 0.076, 0.152, 0.304, 0.38, 0.304, 0.152, 0.076, 0.076) mg/kg B.W/d. After the end of the experiment period, the results showed that the level of (AST, ALT, Creatinine, and Estrogen) increased significantly (P≤0.05) compared to the control group, and the level of these parameters increased significantly(P≤0.05) in the first treatment group compared with the second group. As for the level of (ALP and Urea) in the two treatment groups, it increased significantly (P≤0.05) in comparison with the control group, and there were no significant differences (P&gt;0.05) when comparing the level between the two treatment groups. It is inferred from the results of our study that taking (Dianabol) has a clear negative effect on the liver, kidneys and estrogen in male rabbits, and that this effect increases with the increase in the concentration of the dose used. Keywords: Methandrostenolone, Liver enzymes, Kidney parameters, Estrogen and rabbit

Studying the Effect of the Anabolic Androgen Methandrostenolone on Some Fertility Parameters in Local Male Rabbits

The current study was conducted to investigate the effect of the anabolic androgen Methandrostenolone (Dianabol) on some parameters of fertility in male rabbits. In this experiment, (20) adult male rabbits were used, randomly divided into two groups, each group 10 animals. Control group: The animals were dosed with distilled water. The treatment group: The animals were orally dosed with (Dianabol) within a course that lasted (8) weeks in an ascending manner: (0.076, 0.152, 0.304, 0.38, 0.456, 0.532, 0.608, 0.684) mg/kg/d each dose for consecutive 7days. In the end of the experiment period the results showed a significant decrease (P≤ 0.05) in the ratio of testes and epididymis weight to the body weight of the animal in addition to tissue damage that included a significant decrease (P≤0.05) in the level of germinal epithelium height of the seminiferous tubules and a significant decrease (P≤0.05) in the thickness of the epididymis wall, also our results showed a significant decrease (P&lt;0.05) in the total number of sperm, sperm motility and survival rate in the treatment group animals compared with control group animals. We conclude from this study that anabolic androgen Methandrostenolone has a significant negative effect on fertility in male rabbits.

Nandrolone Supplementation Promotes AMPK Activation and Divergent 18[FDG] PET Brain Connectivity in Adult and Aged Mice.

Decreased anabolic androgen levels are followed by impaired brain energy support and sensing with loss of neural connectivity during physiological aging, providing a neurobiological basis for hormone supplementation. Here, we investigated whether nandrolone decanoate (ND) administration mediates hypothalamic AMPK activation and glucose metabolism, thus affecting metabolic connectivity in brain areas of adult and aged mice. Metabolic interconnected brain areas of rodents can be detected by positron emission tomography using 18FDG-mPET. Albino CF1 mice at 3 and 18months of age were separated into 4 groups that received daily subcutaneous injections of either ND (15mg/kg) or vehicle for 15days. At the in vivo baseline and on the 14th day, brain 18FDG-microPET scans were performed. Hypothalamic pAMPKT172/AMPK protein levels were assessed, and basal mitochondrial respiratory states were evaluated in synaptosomes. A metabolic connectivity network between brain areas was estimated based on 18FDG uptake. We found that ND increased the pAMPKT172/AMPK ratio in both adult and aged mice but increased 18FDG uptake and mitochondrial basal respiration only in adult mice. Furthermore, ND triggered rearrangement in the metabolic connectivity of adult mice and aged mice compared to age-matched controls. Altogether, our findings suggest that ND promotes hypothalamic AMPK activation, and distinct glucose metabolism and metabolic connectivity rearrangements in the brains of adult and aged mice.

New Nonsteroidal Molecules as Blockers of the Steroidogenic Pathway

Background: Testosterone circulating levels decrease in aging. This fact affects the emotional response to captivating pictures. Therefore, naturally increasing androgens within neurons could be a way to improve the mood of aged people. Objective: This study aimed to determine the biological activity of new nonsteroidal derivatives of 2- aminonaphthalene-1,4-dione (2-amino-3-iodonaphthalene-1,4-dione and 2-(iodoamino)-3- methylnaphthalene-1,4-dione) as inhibitors of the aldo-keto reductase 1 enzymes (AKR1C1, AKR1C2). Method: The 2-amino-3-iodonaphthalene-1,4-dione and 2-(iodoamino)-3-methylnaphthalene-1,4- dione were synthesized, and their effect in vivo and in vitro was determined. The human prostate cell membrane was used as a source of steroidogenic enzymes. The 2-amino-3-iodonaphthalene-1,4-dione and 2-(iodoamino)-3-methylnaphthalene-1,4-dione bindings to the androgen receptors were also assayed using cytosol from the rat prostate. In vivo experiments, we determined the effects of 2-amino-3- iodonaphthalene-1,4-dione, 2-(iodoamino)-3-methylnaphthalene-1,4-dione on the weight of androgendependent glands of castrated hamsters treated with testosterone and finasteride or 2-amino-3- iodonaphthalene-1,4-dione or 2-(iodoamino)-3-methylnaphthalene-1,4-dione was determined. Results: 2-amino-3-iodonaphthalene-1,4-dione and 2-(iodoamino)-3-methylnaphthalene-1,4-dione inhibited AKR1C1 enzyme activity with an IC50 value of 420 nM (2-amino-3-iodonaphthalene-1,4-dione) and 1.95 μM (2-(iodoamino)-3-methylnaphthalene-1,4-dione), respectively. They also blocked AKR1C2 with an IC50 value of 300 nM (2-amino-3-iodonaphthalene-1,4-dione) and 1.52 μM (2- (iodoamino)-3-methylnaphthalene-1,4-dione). Thus 2-amino-3-iodonaphthalene-1,4-dione and 2- (iodoamino)-3-methylnaphthalene-1,4-dione prevent the formation of 3α and 3β-androstanediols. Moreover, these compounds did not bind to AR and did not reduce prostate and seminal vesicle weight. The latter is because of the accumulation of dihydrotestosterone, which is an anabolic androgen. Conclusion: 2-amino-3-iodonaphthalene-1,4-dione and 2-(iodoamino)-3-methylnaphthalene-1,4-dione inhibited AKR1C1 and AKR1C2 enzyme activity; consequently, dihydrotestosterone was accumulated in androgen-dependent glands. These derivatives could potentially use therapeutics via direct nasal administration in aged patients, increasing DHT in neurons.

About the Hormone of Youth

DHEA, prasterone, (3β)-3-hydroxyandrost-5-en-17-one, is a natural secondary metabolite that is, mainly in its sulphated form, present in young humans. After the age of 30 its concentration gradually lowers. When it is supplemented to the elderly people, their well-being and sexual functions grow up together with mental capacity. Alternatively, it may help to cure number of diseases. However, as it is considered to be anabolic androgen, i.e., doping, its use is in the Czech Republic limited on the medical prescription only.&#x0D; Full text English translation is available in the on-line version.

Skeletal and gene-regulatory functions of nuclear sex steroid hormone receptors.

The wide variety of sex hormone actions underlie bone growth and health, and their actions mediate gene regulation by the cognate nuclear receptors. Nuclear androgen and estrogen receptors (AR, and ERα/ERβ) are hormone-dependent and DNA binding- transcription regulatory factors, and gene regulation by sex hormones often accompany with chromatin remodeling under aid of a number of co-regulators. As sex hormone biosynthesis is under highly regulated systemic and local regulations, the skeletal actions of sex hormones could be inferred from only the phenotypic abnormalities in skeleton in mouse genetic models deficient of nuclear receptors selectively in specific types of bone cells as well as at specific cell differentiation stages. Anabolic androgen actions and anti-bone resorptive estrogen actions are discussed here from the phenotypic abnormalities in such model mice. Though rapid gene regulation by sex hormones may not require chromatin reorganization, dynamic chromatin reconfiguration looks to facilitate profound and long-term hormonal actions. In this review, we focus the recent findings in gene regulation at a chromatin level, particularly of the function of enhancer RNAs transcribed from strong enhancers, and in the role of liquid-liquid phase separation state in transcription initiation through chromatin reconfiguration.

S2611 When FNH Is Not FNH: The Value of the Multidisciplinary Conference for Management of Hepatic Masses

Introduction: While hepatocellular carcinoma (HCC) can arise spontaneously, the majority of cases are observed in patients with cirrhosis or chronic hepatitis infection. Hepatocellular adenoma is also an important cause of liver mass, but is often found in women and associated with exposure to estrogens. Adenomas can be seen in males, especially those with history of anabolic androgen use. Focal nodular hyperplasia (FNH) is another benign cause of liver mass usually seen in females. We report a case of an undifferentiated liver mass in a healthy male patient that was originally thought to be FNH but turned out to be a more serious condition. Case Description/Methods: An asymptomatic 36-year-old man with unremarkable medical history presented with a liver mass after routine blood work revealed an elevated alkaline phosphatase. Risk factors for liver disease included obesity and hyperlipidemia. Imaging demonstrated a mass in the right hepatic lobe (8.1 x 7.1 x 9.0 cm), with arterial hyperenhancement, followed by isointensity to the liver after the arterial phase. The surrounding parenchyma appeared normal. He had no exposure to hepatitis B or C and his chronic liver disease evaluation was negative. Alpha fetoprotein was normal. Given these findings, the lesion was initially deemed most consistent with FNH. Multidisciplinary review instead favored adenoma or HCC, due to male gender, lesion size, T2 hyperintensity relative to liver, and central areas of high signal intensity that did not fill like a classic central scar. The patient subsequently underwent right hepatectomy. Surgical pathology revealed a well-differentiated hepatocellular neoplasm without invasion of the surrounding vasculature. The lesion had a prominent capsule and consisted of sheets and nodules of well-differentiated hepatic cells. The remainder of the liver parenchyma showed mild steatosis without inflammation or fibrosis. Pathology was reviewed at multiple institutions, with results favoring a well-differentiated HCC or atypical adenoma. Unfortunately, it was difficult to determine whether this mass was benign or malignant. Discussion: In this case, presentation at a multidisciplinary conference was lifesaving. Given that adenomas of this size carry high risk for malignant transformation or rupture, and large HCC often metastasize and can be terminal, surgery was indicated regardless of diagnosis. However, FNH can typically be observed. The patient now follows with Oncology and Hepatology for surveillance imaging and labs every 3 months.Figure 1.: A. Contrast-enhanced MRI demonstrates a large (8.1 x 7.1 x 9.0 cm) right hepatic lobe mass with heterogeneous hyperenhancement in the arterial phase. B. Gross pathology of 9.7cm tumor in right hepatic lobe. C. High magnification of the tumor (H&E) showing unpaired arteries without abnormal thickening of hepatocellular plates.

Prevalence, mental health and substance use of anabolic steroid users: a population-based study on young individuals.

Aims: The use of anabolic androgen steroids to enhance performance is not a modern phenomenon. However, the majority of today's anabolic androgen steroid users are not competitive athletes, but individuals who want to look leaner and muscular. This study aimed to examine the prevalence of anabolic androgen steroid use among young individuals and assess whether their mental health, lifestyle and substance use differ from non-anabolic androgen steroid users. Methods: A population-based study conducted in secondary schools, mean age was 17.3 years. A total of 10,259 participants (50% young women, 1% reported gender as 'other', 49% young men) answered questions on mental health, anabolic androgen steroid use, substance use and sports participation. Statistical analysis included descriptive statistics, t-test, χ2 and logistic regression. Results: The prevalence of anabolic androgen steroid use was 1.6%, and 78% of users were young men. Anabolic androgen steroid users had more anger issues, anxiety, depression, and their self-esteem was lower than among non-anabolic androgen steroid users (P<0.05). A larger proportion of anabolic androgen steroid users, 30%, had attempted suicide compared to 10% of non-users (χ2 (1, 9580) = 57.5, P<0.001). Proportionally, anabolic androgen steroid users were more likely to take medicine for mental health problems and misuse substances than non-users. Participation in non-organised sports, increased anger and body image were associated with increased odds of using anabolic androgen steroids. Conclusions: Anabolic androgen steroid use is a public health threat. It had an alarming effect on the life of individuals who report having used anabolic androgen steroids. Authorities, healthcare workers, parents and others working with young people need to be informed of the signs and risks of anabolic androgen steroid use to reduce future negative implications.

Comparative efficacy and safety of traditional Chinese medicine for lipodermatosclerosis: A protocol for systematic review and network meta-analysis.

Background:Lipodermatosclerosis (LDS) is a severe skin change accompanied by the development of chronic venous disease of the lower extremities. Its main clinical manifestations are erythema, induration, hyperpigmentation, and rough and thickened skin. It may also eventually lead to refractory ulcers, skin necrosis and even cancer. Conventional treatment methods mainly include the intake of oral anabolic hormones or androgen and pressure therapy. However, patients often refuse due to their drug resistance and intolerance. As a clinical irreplaceable treatment method for LDS, traditional Chinese medicine (TCM) has not been compared of the safety and effectiveness so far. Therefore, we cannot wait to use a method to compare the efficacy of TCM for LDS systematically, such as network meta-analysis (NMA).Methods:We will retrieve the relevant Chinese and English databases comprehensively. All the randomized controlled trials of TCM for LDS from January 2015 to September 2020 will be included. Under the guidance of inclusion criteria, 2 researchers will screen the literature, then assess the risk of bias and extract data. We will use Bayesian NMA to evaluate all available evidence in STATA 14.0 and WinBUGS software.Results:This study will use Bayesian NMA to evaluate the efficacy and safety of TCM for LDS.Conclusion:This study provide a reliable theoretical basis for the clinical application of TCM in the treatment of LDS, and contribute to the formulation of treatment guidelines for LDS.

Aortopathic effect of androgenic anabolic steroids.

Anabolic androgens have been reported to be associated with cardiovascular complications. One study revealed that increase in vascular stiffness in bodybuilders is associated with anabolic androgens and improvement in vascular function may occur following anabolic androgens discontinuation. The aim of this study was to investigate any possible relation between aortic elastic properties and anabolic androgens. Study population was divided into 3 groups: Group-1 [n = 35] consisted of bodybuilders who denied any current or previous use of anabolic androgens. Group-2 [n = 18] was bodybuilders with regular using of anabolic androgens for at least 2year prior to the start of our study. Group-3 was 13 healthy age-matched sedentary men as a control group. Cardiac echocardiography was performed in the bodybuilders and controls and indexes of aortic function were calculated. Aortic stiffness was approximately twofold higher in anabolic androgens user bodybuilders compared with drug-free bodybuilders [P < 0.001]. The present study demonstrates that chronic anabolic androgens use clearly produces significant decrease in the elastic properties of aorta.

Potential effects of long-term abuse of anabolic androgen steroids on human skeletal muscle.

We have previously evaluated muscle functions and morphology in power athletes of long term (5 to15 years) abuse of anabolic androgen steroids (AAS; Doped) and in clean power athletes (Clean), and observed significant improvements in both muscle morphology and muscle functions in Doped. To our knowledge, the effects of long term AAS abuse on human muscle protein profile have never been studied. The study examined further the muscle biopsies using a two-dimensional difference gel electrophoresis (2D DIGE) for proteomic screening and protein expression. Cellular localization/distribution of specific proteins identified by proteomic analysis was examined using immunohistochemistry (IHC). Different protein profiles were observed between Doped and Clean, and a valid orthogonal projection of latent structure discriminant analysis model was built (N.=16, x=5, R2=0.88/Q2=0.84, P=0.0005), which separated Doped from Clean. Liquid chromatography followed by tandem spectrometry identified 14 protein spots (representing nine different proteins) of significant difference in relative quantity (P<0.05), of which nine spots were down-regulated in Doped compared with Clean. IHC revealed no significant alteration in cellular localization in phosphoglucomutase-1 and heat shock protein beta-1, but indeed in two reference proteins desmin and F-actin in Doped. Long term abuse of AAS in combination with training is potentially associated with alterations in skeletal muscle protein profile and protein expression, and structural proteins rather than non-structural proteins are preferentially affected in cellular localization/distribution.

Physiological And Histological Toxic Effects Of Different Doses Of Nandrolone Decanoate On The Kidney Of Male Mice

Anabolic androgen steroids are widely used among athletes to increase muscles mass. Some patients with chronic kidney disease are also used these drugs. But the effect of these drugs on the kidney structure receives less attention.The current study was performed to investigate the histopathological effects of nandrolone decanoate injection in kidney tissues of adult male mice. Thirty adult male mice (balb / c) were randomly divided into three groups (10 mice in each group): two groups treated were injected subcutenously in the distled region of femur with 50 and 100 mg / kg b.w of Nandrolone Decanoate every 2 days for 4 weeks , while the control group was injected with 0.9% normal sline solution. Two physiological parameters were performed including urea and creatinine levels. The results showed that there was a significant increase (P

Association between fragmented QRS complexes and left-ventricular dysfunction in anabolic androgenic steroid users

Background: Anabolic androgen steroid (AS) use has adverse effects on left ventricular functions, such as fibrosis development. Fragmented QRS is an important marker of myocardial fibrosis, while speckle-tracking echocardiographyis a method used to show subclinical left ventricle dysfunction. In this study, we examined the the ability of fQRS + to detect left ventricle fibrosis by speckle tracking echocardiography (STE) in AS users.Methods: The study included a total of 181 healthy athletes. Athletes were divided into two groups as AS users (n = 89) and non-AS users (n = 92). Then, athletes using AS were divided into two groups as fQRS+ (n = 52) and fQRS− (n = 37). In both groups, the arithmetic mean of three images was used to obtain the left ventricle global longitudinal strain (LV-GLS). The E/SRe ratio was also calculated and analysed.Results: There were significant differences between the AS users and non-AS users in terms of, E/SRe (55.7 ± 17.9 vs 50.3 ± 14.8; p = 0.015), LV-GLS (23.1 ± 1.9 vs 24.0 ± 1.7; p = 0.001), and fQRS (18.5% vs 6%; p = 0.005). When subgroup analysis was performed, both LV-GLS and E/SRivr were found to be poor in the fQRS + group. When multiple linear regression analysis was performed, we determined fQRS as an independent predictor for LV-GLS and E/SRivr ratio.Conclusion: In conclusion, our study demonstrated that fQRS is a parameter that can beused to determine left ventricle subclinical systolic and diastolic dysfunction in AS users. It can be used for cessation of drug use, especially in long-term use.

2390 Trenbolone-Induced Liver Injury

INTRODUCTION: Anabolic-androgenic steroid abuse has been steadily increasing in the general population. According to a 2014 study, approximately 1 in 50 students in the 12th grade reported using anabolic steroids. Trenbelone acetate is a synthetic anabolic androgen which is an agonist of the androgen receptor and most often used in cattle. CASE DESCRIPTION/METHODS: A 23 year old male with no significant past medical history presented with complaints of jaundice and generalized weakness which began 10 days prior to presentation. Patient endorsed weekly IM trenbelone 1000 mg weekly over the last 8 weeks. Physical examination was remarkable for icterus and appropriate mentation. Initial investigations reflected a total bilirubin of 13.44 mg/dL, AST 159 IU/L, ALT 425 IU/L, PT 11.0, INR 1.0, and Alk Phos of 142. Serologies were negative for viral hepatitis, anti-mitochondrial antibody, anti-smooth muscle antibody and ANA of 1:40. A liver ultrasound reported normal liver size without biliary obstruction. Patient's liver chemistries improved over the next three days and he was discharged with total bilirubin of 12.54 mg/dL, AST 135 IU/L, ALT 320 IU/L, PT 11.0, INR 1.0 and Alk Phos of 121. Patient advised to abstain from any future use of trenbelone. On repeat labs in 10 days, his total bilirubin of 29.50 mg/dL, AST 78, ALT 123, PT 20.1, INR 1.85 and Alk Phos 242. Physical examination noted worsening jaundice overall along with icterus but mentation remained appropriate. Patient denied any new medications and no further use of trenbelone since discharge. Patient's liver chemistries remained stable and he underwent MRI abdomen which was unremarkable. Patient was discharged home on ursodiol 300 mg BID. Patient's liver chemistry improved in one week and returned to baseline in one month. DISCUSSION: Anabolic steroids have been linked to four different forms of liver injury including an acute cholestatic syndrome such as in our patient, elevation in serum enzymes, chronic vascular injury and hepatic tumors including adenomas and hepatocellular carcinoma. Mechanism of cholestatic syndrome is not well defined in this type of injury. Urosdiol has been used in the past for treatment however efficacy has not been shown in a study. Healthcare provides managing patients with elevated liver chemistries should able to recognize anabolic induced liver injury given increasing use and ease of availability of such performance enhancing drugs.