Anabolic steroid users have lower insulin sensitivity

Young men who were abusing or had previously abused anabolic androgenic steroids demonstrated lower insulin sensitivity compared with controls, according to findings from Denmark published in Clinical Endocrinology.

“A recent meta-analysis indicates that approximately 6% of young men and 18% of male recreational athletes have experience with anabolic androgenic steroid abuse,” Jon Jarlov Rasmussen, MD, of the Center of Endocrinology and Metabolism at Copenhagen University Hospital, and colleagues wrote. “Male hypogonadism is associated with impaired insulin sensitivity. We and others recently reported that a high proportion of former anabolic androgenic steroid abusers have symptoms of hypogonadism and subnormal plasma testosterone concentrations years after anabolic androgenic steroid discontinuation. Accordingly, former anabolic androgenic steroid abuse could be a risk factor for hypogonadism-related decreases in insulin sensitivity.”

The researchers recruited men aged 18 to 50 years from the greater Copenhagen area, including 37 current anabolic androgenic steroid abusers, 33 former abusers and 30 controls. Former abusers stopped anabolic androgenic steroid use for a mean 2.5 years.

Rasmussen and colleagues evaluated the men’s insulin sensitivity and measured adiponectin and leptin from overnight fasting blood samples. Researchers also assessed participants’ fat distribution and body composition with DXA.

Current steroid abusers had a 26% lower Matsuda index score than controls (95% CI; -45% to -1%), the researchers reported, while former abusers had a 39% lower score (95% CI; -55% to -18%). Current steroid abusers showed significantly higher levels of testosterone than controls, while former abusers were “subnormal.” Overall Matsuda indices did not vary between the current and former abuser groups.

Mean visceral adipose tissue was higher among current steroid abusers compared with controls (388 cm³ vs. 293 cm³; P < .001), Rasmussen and colleagues wrote. Former abusers had the highest body fat percentages and leptin concentrations of any group. Multivariate linear regression showed that visceral adipose tissue was independently predictive of lower Matsuda index scores among men who were currently abusing steroids compared with controls, the researchers wrote, while in former abusers, body fat percentage was predictive of a lower Matsuda index.

“In conclusion, both current and former anabolic androgenic steroid abusers displayed lower insulin sensitivity which could be mediated by higher [visceral adipose tissue] and total body fat percentage, respectively,” the researchers wrote. “These findings suggest increased risk of developing the metabolic syndrome and [type 2 diabetes] among men with anabolic androgenic steroid abuse which should be investigated further.” – by Andy Polhamus

Disclosure: Rasmussen and Kistorp report receiving grants from Antidoping Denmark. No other researchers report any relevant financial disclosures.