anabolic steroids and HDL

Last reviewed 10/2023

Anabolic Androgenic Steroids (AAS) and abnormal plasma lipoproteins

  • AAS abuse in athletes increase low-density lipoprotein (LDL) levels by >20% and decrease high-density lipoprotein (HDL) levels by 20% to 70% (1,2)
  • HDL decline seen particularly with use of nonaromatizable androgens - significant decrease in high-density lipoprotein cholesterol with nonaromatizable androgens like stanozolol
    • decline is significantly less with use of aromatizable androgens such as testosterone (3)

  • steroid hormones alter serum lipoprotein levels via the lipolytic degradation of lipoproteins and their removal by receptors through modification of apolipoprotein A-I and B synthesis

  • estimated that these lipoprotein abnormalities increase the risk for coronary artery disease by three- to sixfold

  • onset and reversibility of lipid abmormalities associated with AAS use

    • abnormalities of HDL and LDL may arise within 9 weeks of AAS self-administration

    • lipid effects seem to be reversible and may normalize 5 months after discontinuation

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