Low HDL and anabolic steroids

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

Reference:

• Sader MA et al. Androgenic anabolic steroids and arterial structure and function in male bodybuilders. J Am Coll Cardiol. 2001;37:224-30.
• Achar S et al. Cardiac and Metabolic Effects of Anabolic-Androgenic Steroid Abuse on Lipids, Blood Pressure, Left Ventricular Dimensions, and Rhythm. Am J Cardiol. 2010 Sep 15; 106(6): 893-901.
• Basaria S.Androgen abuse in athletes: detection and consequences. J Clin Endocrinol Metab. 2010 Apr;95(4):1533-43