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Abstract
Introduction The use of androgenic anabolic steroids (AASs) among recreational athletes is steadily increasing. However, knowledge regarding the potentially harmful effects of AAS primarily originates from case reports and small observational studies. This large-scale study aims to investigate the impact of AAS use on vascular plaque formation, preclinical coronary disease, cardiac function, circulating cardiovascular risk markers, quality of life (QoL) and mental health in a broad population of illicit AAS users.
Methods and analyses A nationwide cross-sectional cohort study including a diverse population of men and women aged ≥18 years, with current or previous illicit AAS use for at least 3 months. Conducted at Odense University Hospital, Denmark, the study comprises two parts. In part A (the pilot study), 120 recreational athletes with an AAS history will be compared with a sex-matched and age-matched control population of 60 recreational athletes with no previous AAS use. Cardiovascular outcomes include examination of non-calcified coronary plaque volume and calcium score using coronary CT angiography, myocardial structure and function via echocardiography, and assessing carotid and femoral artery plaques using ultrasonography. Retinal microvascular status is evaluated through fundus photography. Cardiovascular risk markers are measured in blood. Mental health outcomes include health-related QoL, interpersonal difficulties, body image concerns, aggression dimensions, anxiety symptoms, depressive severity and cognitive function assessed through validated questionnaires. The findings of our comprehensive study will be used to compose a less intensive investigatory cohort study of cardiovascular and mental health (part B) involving a larger group of recreational athletes with a history of illicit AAS use.
Ethics and dissemination The study received approval from the Regional Committee on Health Research Ethics for Southern Denmark (S-20210078) and the Danish Data Protection Agency (21/28259). All participants will provide signed informed consent. Research outcomes will be disseminated through peer-reviewed journals and scientific conferences.
Trial registration number NCT05178537.
- Cardiovascular imaging
- General endocrinology
- Cardiology
- Cardiomyopathy
- Sex steroids & HRT
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Footnotes
X @ADiederichsen
Contributors We, the authors of this manuscript, hereby affirm that we have collectively met the criteria for authorship as outlined by the International Committee of Medical Journal Editors (ICMJE). JF, AD and MA: conception and design of the study. LFB, LLC, MA, DG, AD, JSL, CMK and JF contributed to writing the protocols for ethical approval or funding. This contributor statement attests to the fact that all authors have made substantial contributions to the conception, design, data acquisition, analysis, interpretation, drafting, critical revision and final approval of the manuscript. Furthermore, each author takes responsibility for the integrity of the work as a whole. AI (ChatGPT) was employed solely for the purpose of correcting grammar and errors within the manuscript.
Funding The study is funded by the Novo Nordisk Foundation (to JF; grant number 0065138) and Anti Doping Denmark (To LLC and JF; no grant number).
Competing interests None declared.
Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.
Provenance and peer review Not commissioned; externally peer reviewed.
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