Further considerations for the diagnostic evaluation of anabolic androgenic steroid (AAS) associated hepatotoxicity

Fergal M. Grace, Michael T. Graham, Julien S. Baker, Nick Sculthorpe, Adrian Haggett, James Brouner, Lisa Cole, Bruce Davies

Research output: Contribution to journalArticlepeer-review


PURPOSEThe present experiment examined the potential hepatotoxic effects resulting from long term (>20years) of AAS use. This study also examined the potential link between creatine kinase (CK) and the liver aminotransferrases; alanine aminotransferrase (ALT), aspartate aminotransferrase (AST), which were also be markedly elevated as a result of bodybuilding exercises.
METHODSSubjects were divided into four distinct groups; AAS users (n=10) who were still using AAS at time of testing results: AAS users (n=10) who had been abstinent for a period greater than three months [mean + Standard Deviation (S.D): 5 + 2.3 months] (SA), bodybuilding controls (n=10) who did not use any pharmacological ergogenic aids (BC), and (n=9) sedentary male controls. Creatine kinase (CK), alanine aminotransferrase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma glutamyltransferase (γGT), albumin (ALB), bilirubin (BIL) and total protein (TOT-P) were analysed by dry slide technology on an Ortho Vitros 950 analyser (Ortho Clinical Diagnostics, Amersham, Bucks, UK). Data were analysed using the SPSS 10.0 for Windows statistical package. Data are presented as means + standard deviations (S.D.) Group differences were analysed using a one way ANOVA followed by a post-hoc Tukey test. Pearson product bivariate procedure was used to examine correlations between variables. Statistical significance was accepted at the P<0.05 level.
RESULTSBilirubin (BIL) was significantly higher in both AAS using groups (P<0.05) compared with the BC and SC groups. CK, AST and ALT concentrations were not significantly different between SU, SA or BC, but were significantly lower (P<0.05) in the SC group. Furthermore, there were no differences between groups for gamma glutamyl transpeptidase (γGT). Linear regression indicated relationships between CK and AST (r = 0.821; P<0.01), and with CK and ALT (r = 0.557; P<0.01), suggesting aminotransferrase alterations as a consequence of muscle damage, rather than hepatotoxicity.
CONCLUSIONThis study supports the contention that physicians should diagnostically evaluate both CK and gamma glutamyl transpeptidase (γGT) levels in the diagnosis of AAS induced hepatotoxicity.
Original languageEnglish
Pages (from-to)396-397
Number of pages2
JournalMedicine & Science in Sports & Exercise
Issue number5
Publication statusPublished - May 2009
Externally publishedYes


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