Recreational Anabolic-Androgenic Steroid Use Associated with Liver Injuries among Brazilian Young Men.

Background: The recreational use of anabolic-androgenic steroids (AAS) has reached alarming levels among healthy people. However, several complications have been related to consumption of these drugs, including liver disorders. Objective: To evaluate the prevalence of liver injuries in young Brazilian recreational AAS users. Methods: Between February/2007 and May/2012 asymptomatic bodybuilders who were 18years old and reported AAS use for 6 months were enrolled. All had clinical evaluations, abdominal ultrasound (AUS), and blood tests. Results: 182 individuals were included in the study. The median age (interquartile range) was 26.0years (22.0-30.0) and all were male. Elevated liver enzyme levels were observed in 38.5% (n = 70) of AAS users, and creatine phosphokinase was normal in 27.1% (n = 19) of them. Hepatic steatosis was observed by AUS in 12.1% of the sample. One individual had focal nodular hyperplasia and another had hepatocellular adenoma. One case each of hepatitis B and C virus infection was found. A diagnosis of toxic liver injury was suggested in 23 (12.6%) AAS users without a history of alcohol or other medications/drugs consumption, or evidence of other liver diseases. Conclusions/Importance: Young Brazilian recreational AAS users presented a wide spectrum of liver injuries that included hepatotoxicity, fatty liver, and liver neoplasm. They also presented risk factors for liver diseases such as alcohol consumption and hepatitis B and C virus infection. The results suggest that the risk of AAS use for the liver may be greater than the esthetic benefits, and demonstrate the importance of screening AAS users for liver injuries.