The effects of nonphysician prescribed, self-obtained, self-administered exogenous anabolic-androgenic steroids and testosterone on plasma total, high- and low-density lipoprotein cholesterol (HDLC, LDLC), and triglycerides were evaluated in 14 adult white men, 11 body builders and 3 power weight lifters. Lipids and lipoprotein cholesterols were quantified during active physical conditioning, both on (for at least 1 month, X ± SD 2.1 ± 1.8 months) and off (for at least 4 months, 7.3 ± 2.7 months) self-administered exogenous androgenic steroids. The subjects took 50 to 100 mg methandrostenolone daily plus weekly injections of testosterone 100 to 200 mg and nandrolone decanoate 100 to 200 mg per week. Mean (SD) HDLC on exogenous androgenic steroids, 29 ± 8 mg/dL, was severely depressed, and was less than 50% of the consistently elevated mean HDLC when exogenous steroids were not used (61 ± 14 mg/dL, P < .01 for paired differences). During anabolic steroid use, HDLC was ≤ the age- race- and sex-specific 10th percentile in 11 of the 14 men, whereas while off anabolic steroids, HDLC was ≥ the 90th percentile in 7 of the 13 men, and in the top quartile for 3 of the remaining 6 men. Mean LDLC was higher on androgenic steroids (150 ± 44) than off (125 ± 38 mg/dL), P < .05 for paired differences. The ratio of LDLC/HDLC during exogenous steroid use (6.0 ± 3.7) was nearly triple the ratio obtained when steroids were not taken (2.2 ± 1.0), P < .01 for paired differences. The remarkable reductions in HDLC and increments in LDLC/HDLC on exogenous androgenic steroids were not related to changes in total body weight or Quetelet index. Widespread and habitual use of nonprescribed exogenous androgenic-anabolic steroids by body builders and weight lifters sharply and uniformly reduces their HDLC and elevates their LDLC, producing an atherogenic lipoprotein cholesterol profile, which is in marked contrast to the high HDLC and relatively low LDLC observed in the same men during training but not receiving anabolic-androgenic steroids.
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