History of Anabolic Androgenic Abuse Is Associated with Increased Insulin Resistance and Increased Visceral Fat in Young Men

Program: Abstracts - Orals, Poster Previews, and Posters
Session: SUN 176-202-Male Reproductive Endocrinology and Male Reproductive Tract (posters)
Bench to Bedside
Sunday, April 3, 2016: 1:15 PM-3:15 PM
Exhibit/Poster Hall (BCEC)

Poster Board SUN 194
Jon Bjarke Jarløv Rasmussen*1, Morten Schou1, Christian Selmer1, Jens Faber1, Finn Gustafsson2 and Caroline Kistorp1
1Herlev University Hospital, Herlev, Denmark, 2Rigshospitalet, Copenhagen, Denmark
Introduction: The association between hyperandrogenism and insulin resistance (IR) and abdominal obesity is well-known in women. However, in men IR and abdominal obesity have predominantly been reported in relation to hypogonadism but the relation to hyperandrogenism is unresolved.

Aim: To study the impact of supraphysiological levels of androgens on IR in men.

Methods and Results: Cross-sectional study among younger men (≤ 50 years) including three groups: ongoing abusers of anabolic androgenic steroids (AAS), n = 35 (age 31.8 ± 8.7 years, mean (SD)), former AAS abusers, n = 17 (age 35.5 ± 6.6 years) median (IQR) abstinence duration from AAS of 1.9 (1.0 – 3.5) years and an age-matched control group who had never used AAS, n = 21 (age 32.0 ± 6.8 years). All participants were engaged in recreational strength training. Ongoing and former AAS abusers did not differ significantly in terms of duration of AAS abuse, 144 (78 – 234) weeks during 5.0 (2.0 – 14.0) years vs. 125 (49 – 270) weeks during 10.0 (3.0 – 11.0) years, P=0.29. A 120 min oral glucose tolerance test (OGTT) was performed after a minimum of 8-hour overnight fasting. Plasma glucose and serum insulin were obtained at five time points during the OGTT: 0, 30, 60, 90 and 120 min. We used the Matsuda (1) and HOMA2 IR (2) indexes as measures of IR. Body composition and visceral adipose tissue (VAT) were assessed using a DEXA-scan. Ongoing and former AAS abusers had significantly lower Matsuda index (geometric mean (95%CI) 7.40 (6.15 – 8.92) vs. 5.71 (4.32 – 7.54) vs. 9.57 (8.18 – 11.20), P <0.01) and higher HOMA2 IR index (1.00 ± 0.46 vs. 1.19 ± 0.55 vs. 0.85 ± 0.27, P=0.02) reflecting increased IR compared with the control group. Despite that ongoing AAS abusers had significantly higher lean body mass and lower body fat % than controls and former AAS abusers (25.5 ± 2.6 kg/m2 vs. 21.4 ± 2.2 kg/m2  and 21.9 ± 3.0 kg/m2, P<0.01) and (14.1 ± 2.4 % vs. 17.6 ± 4.5 % and 20.0 ± 2.5 %, P<0.01). Ongoing AAS abusers had a higher trunk-limb fat mass ratio as compared with the control group indicating a more abdominal fat distribution (P=0.04). Interestingly, VAT mass was higher in ongoing 336 (299 – 424) g and former AAS abusers 353 (232 – 434) g compared with the control group 258 (230 – 354) g, P=0.03. Further, in linear regression models VAT mass was strongly associated with HOMA2 IR index(p<0.01) and negatively associated with Matsuda index (p<0.01) in the study cohort.

Conclusions:  Our results indicate that supraphysiological levels of androgens leads to increased IR, abdominal fat distribution and increased VAT compared with men who had never used AAS. Moreover, the increased IR and VAT persist years after discontinuation of AAS. Hence, not only hypogonadism but also hyperandrogenism induce IR which could be mediated by VAT in men.

(1) Matsuda et al. Diabetes Care. 1999 Sep;22(9):1462-70. (2) Levy et. al Diabetes Care. 1998 Dec: 21:2191-2192

Nothing to Disclose: JBJR, MS, CS, JF, FG, CK

*Please take note of The Endocrine Society's News Embargo Policy at https://www.endocrine.org/news-room/endo-annual-meeting/pr-resources-for-endo

Sources of Research Support: Financial Sources of Research Support: AntiDoping Denmark (no specific grant number), Research Foundation of Herlev University Hospital (no specific grant number), Danish Heart Foundation (grant number: 15-R99-A5797-22952), Faculty Scholarship from University of Copenhagen to JR (no specific grant number)