Physical Effects of Anabolic-androgenic Steroids in Healthy Exercising Adults: A Systematic Review and Meta-analysis.

Many athletes use anabolic-androgenic steroids (AAS) for physical enhancement but the magnitude of these gains and associated adverse effects has not been rigorously quantified. MEDLINE, EMBASE, Cochrane, SPORTDiscus, and PsycINFO were searched to identify randomized placebo-controlled trials of AAS in healthy exercising adults that reported one of the following outcomes: muscular strength, body composition, cardiovascular endurance, or power. Two authors appraised abstracts to identify studies for full-text retrieval; these were reviewed in duplicate to identify included studies. Study quality was assessed using the Cochrane method. Data were extracted in duplicate and pooled using the DerSimonian and Laird random effects model and to calculate the ratio of mean outcome improvement where possible. Pooled standardized mean difference (SMD) in muscle strength between AAS and placebo was 0.27 (95% confidence interval, 0.07-0.47; I = 12.7%; 21 studies). Change in strength was 52% greater in the AAS group compared to placebo. The SMD for change in lean mass between AAS and placebo was 0.62 (95% confidence interval, 0.35-0.89; I = 26%; 14 studies). Due to missing data, fat mass, cardiovascular endurance, power, and adverse effects were summarized qualitatively. Only 13 of 25 studies reported adverse effects including increased low density lipoprotein (LDL), decreased high density lipoprotein (HDL), irritability, and acne. In healthy exercising adults, AAS use is associated with a small absolute increase in muscle strength and moderate increase in lean mass. However, the transparency and completeness of adverse effect reporting varied, most studies were of short duration, and doses studied may not reflect actual use by athletes.

Comparison of Circumference Body Composition Measurements and Eight-Point Bioelectrical Impedance Analysis to Dual Energy X-Ray Absorptiometry to Measure Body Fat Percentage.

BACKGROUND: To compare the circumference measurement (CM) body composition method and 8-point segmental bioelectrical impedance analysis (DSM-BIA) to dual energy X-ray absorptiometry (DEXA) in military members. OBJECTIVE: The objective was to compare three body composition methods. Our hypothesis was the CM is as accurate as DSM-BIA and DEXA in assessing body fat percentage (%BF). DESIGN: Cross sectional, observational study. PARTICIPANTS/SETTING: Healthy active duty military males and nonpregnant females. Seventy-six participants (mean age 35.0 ± 9.7 years, mean body mass index 28.9 ± 4.7 kg/m2), outpatient clinic setting was used. STATISTICAL ANALYSES: Agreement between DEXA and the other two methods was examined using an intraclass correlation coefficient (ICC) using the two-way random method with absolute agreement. Repeated measures analysis of covariance was used to examine the effect of gender and waist circumference on differences in %BF. RESULTS: The agreement of DSM-BIA with DEXA for females was ICC = 0.93 (95% confidence interval [CI]: 0.87-0.96) and for males, ICC = 0.89 (95% CI: 0.78-0.94). For the agreement of CM with DEXA, the ICC for females was 0.83 (95% CI: 0.71-0.91) and for males the ICC = 0.72 (95% CI: 0.49-0.85). For females with smaller waists (<81.3 cm), the DSM-BIA underestimated the DEXA measurement by a mean of 1.6% (95% CI: 0.5-2.6%). For males with larger waists (≥95.3 cm), the DSM-BIA overestimated the DEXA measurement by a mean of 2.6% (95% CI: 0.9-4.3%). For females with larger waists (≥81.3 cm), the CM overestimated the DEXA %BF by an average of 2.4% (95% CI: 0.7-4.1%). CONCLUSION: There was good agreement between the three methods assessed in this study. Both waist circumference and gender had an effect on the accuracy of the DSM-BIA and CM measurements.