Anabolic-androgenic steroids: a possible new risk factor of toxicant-associated fatty liver disease

Authors

  • Paulo Adriano Schwingel,

    1. Programa de Pós-Graduação em Medicina e Saúde (PPgMS), Faculdade de Medicina da Bahia, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
    2. Laboratório de Pesquisa do Exercício (LAPEX), Faculdade Social da Bahia (FSBA), Salvador, Bahia, Brazil
    Search for more papers by this author
  • Helma P. Cotrim,

    1. Programa de Pós-Graduação em Medicina e Saúde (PPgMS), Faculdade de Medicina da Bahia, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
    Search for more papers by this author
  • Bernardo Rios Salles,

    1. Programa de Pós-Graduação em Medicina e Saúde (PPgMS), Faculdade de Medicina da Bahia, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
    Search for more papers by this author
  • Carlos Eduardo Almeida,

    1. Programa de Pós-Graduação em Medicina e Saúde (PPgMS), Faculdade de Medicina da Bahia, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
    Search for more papers by this author
  • Crimério Ribeiro dos Santos Jr,

    1. Laboratório de Pesquisa do Exercício (LAPEX), Faculdade Social da Bahia (FSBA), Salvador, Bahia, Brazil
    Search for more papers by this author
  • Bruno Nachef,

    1. Programa de Pós-Graduação em Medicina e Saúde (PPgMS), Faculdade de Medicina da Bahia, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
    Search for more papers by this author
  • Antonio Ricardo Andrade,

    1. Programa de Pós-Graduação em Medicina e Saúde (PPgMS), Faculdade de Medicina da Bahia, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
    Search for more papers by this author
  • Cláudio C. Zoppi

    1. Laboratório de Pesquisa do Exercício (LAPEX), Faculdade Social da Bahia (FSBA), Salvador, Bahia, Brazil
    Search for more papers by this author

Correspondence
Helma Pinchemel Cotrim, MD, Programa de Pós-Graduação em Medicina e Saúde (PPgMS), Complexo Universitário Professor Edgard Santos, Rua Augusto Viana, s/n, 5o. andar, Canela, Salvador, Bahia CEP 40110-060, Brazil
Tel/Fax: +55 71 3276 2373
e-mail: hpcotrim@ufba.br

Abstract

Background: Industrial toxin and drugs have been associated with non-alcoholic fatty liver disease (NAFLD); in these cases, the disease has been termed toxicant-associated steatohepatitis (TASH).

Aim: This study hypothesizes that the use of anabolic-androgenic steroids (AAS) could also be a risk factor to TASH or better toxicant-associated fatty liver disease (TAFLD) development.

Methodology: Case–control study including 180 non-competitive recreational male bodybuilders from August/2007 to March/2009. Ninety-five had a history of intramuscular AAS use (cases; G1) and 85 were non-users (controls; G2). They underwent a clinical evaluation and abdominal ultrasound, and their blood levels of aminotransferases, creatine phosphokinase (CPK), lipids, glucose and insulin were measured. TAFLD criteria: history of AAS use >2 years; presence of hepatic steatosis on ultrasound and/or aminotransferase alterations with normal CPK levels; exclusion of ethanol intake ≥20 g/day or use of other drugs; and exclusion of obesity, dyslipidaemia, diabetes and other liver diseases. Homeostasis model assessment for insulin resistance ≥3 was considered insulin resistant. Independent t-test, odds ratio (OR) and 95% confidence intervals (95% CI) were calculated.

Results: All cases were asymptomatic. Clinical and laboratorial data were similar in G1 and G2 (P>0.05). TAFLD criteria were observed in 12.6% of the G1 cases and 2.4% of controls had criteria compliant with non-alcoholic fatty liver related to metabolic conditions. OR was 6.0 (95% CI: 1.3–27.6).

Conclusions: These results suggest that AAS could be a possible new risk factor for TAFLD. In this type of fatty liver disease, the individuals had a low body fat mass and they did not present insulin resistance.

Ancillary