Anabolic-androgenic steroid (AAS) is responsible for muscle building and masculinizing. Using AAS can enhance muscle development and strength, and improve athletic performance. AAS abuse is not only seen in sport. Research has shown that there is an increasing number of adolescent AAS abusers. Adolescents are at a critical period of physical and mental development. Sex hormones are one of the important physiological factors affecting the development of their bodies and brains. Long-term or high-dose AAS treatment is likely to cause irreversible damage to their nervous system and psychological behavior, and these effects are easily overlooked. The article reviewed the long-term adverse effects of AAS on psychological behavior, emotion, cognitive functions and the nervous system of adolescents.
Adolescent ; Anabolic Agents ; pharmacology ; Cognition ; drug effects ; Humans ; Nervous System ; drug effects ; Steroids ; pharmacology ; Substance-Related Disorders

Wnt/β-catenin signaling plays a critical role in the achievement of peak bone mass, affecting the commitment of mesenchymal progenitors to the osteoblast lineage and the anabolic capacity of osteoblasts depositing bone matrix. Recent studies suggest that this evolutionarily-conserved, developmental pathway exerts its anabolic effects in part by coordinating osteoblast activity with intermediary metabolism. These findings are compatible with the cloning of the gene encoding the low-density lipoprotein related receptor-5 (LRP5) Wnt co-receptor from a diabetes-susceptibility locus and the now well-established linkage between Wnt signaling and metabolism. In this article, we provide an overview of the role of Wnt signaling in whole-body metabolism and review the literature regarding the impact of Wnt signaling on the osteoblast's utilization of three different energy sources: fatty acids, glucose, and glutamine. Special attention is devoted to the net effect of nutrient utilization and the mode of regulation by Wnt signaling. Mechanistic studies indicate that the utilization of each substrate is governed by a unique mechanism of control with β-catenin-dependent signaling regulating fatty acid β-oxidation, while glucose and glutamine utilization are β-catenin-independent and downstream of mammalian target of rapamycin complex 2 (mTORC2) and mammalian target of rapamycin complex 1 (mTORC1) activation, respectively. The emergence of these data has provided a new context for the mechanisms by which Wnt signaling influences bone development.
Anabolic Agents ; beta Catenin ; Bone Development ; Bone Matrix ; Clone Cells ; Cloning, Organism ; Fatty Acids ; Glucose ; Glutamine ; Lipoproteins ; Metabolism* ; Osteoblasts* ; Sirolimus

Stevens-Johnson syndrome (SJS) is characterized by mucocutaneous tenderness and typical hemorrhagic erosions, erythema and epidermal detachment presenting as blisters and areas of denuded skin. SJS is often observed after drug use as well as after bacterial or viral infections. Several drugs are at high risk of inducing SJS, but there are no cases in the English literature regarding anabolic steroid use triggering SJS. In our paper, we describe a case in which use of anabolic androgenic steroids (AAS) was associated with SJS. The patient participated in competitive body-building and regularly took variable doses of AAS. Initial symptoms (headache, weakness, pharyngodynia, and fever) were ignored. After a week he presented to the Emergency Department with a burning sensation on the mouth, lips, and eyes. Painful, erythematous, maculopapular, and vesicular lesions appeared all over the body, including on the genitals. During hospitalization, he also developed a cardiac complication. The patient had not taken any drugs except AAS.
Anabolic Agents ; Blister ; Burns ; Emergency Service, Hospital ; Erythema ; Hospitalization ; Humans ; Lip ; Mouth ; Oral Manifestations ; Sensation ; Skin ; Steroids* ; Stevens-Johnson Syndrome* ; Stomatitis

Osteoporosis is a metabolic bone disease that is characterized by low bone mass resulting from an increase in bone resorption relative to bone formation. The most current therapies for osteoporosis have focused on inhibiting bone resorption by osteoclasts. The purpose of this study is to develop new anabolic agents for treatment of osteoporosis that have fewer risks compared to conventional therapies. We searched the natural products that were derived from the traditional Asian medicines which have been used for treatment of bone related diseases. Icaritin is a flavonoid glycoside derived from the herb Epimedium which has beneficial effects on bone formation. To determine the effect of icaritin on bone formation, we examined the effect of icaritin on MC3T3-E1 cell proliferation and differentiation. For determining the effects of icaritin on proliferation, we performed the MTT assay using MC3T3-E1 cells. To evaluate whether icaritin could promote the osteogenic differentiation of MC3T3-E1 cells, alkaline phosphatase (ALP) activity and mRNA expressions of Runx2, osteocalcin (OCN), RANKL, and osteoprotegerin (OPG) were determined. Icaritin increased MC3T3-E1 cell proliferation. Icaritin increased the ALP activity of MC3T3-E1 cells on 72 hour culture in osteogenic media. mRNA expression of Runx2 was increased after 24 hour culture with icaritin. mRNA expression of osteocalcin was increased after 72 hour culture with icaritin. In addition, icaritin increased the mRNA expressions of OPG and RANKL. However, icaritin increased the mRNA expression of OPG much more than that of RANKL, and then, it increased the OPG/RANKL ratio. These results suggest that icaritin promotes osteogenic differentiation of osteoblasts and decreases osteoclast formation regulated by osteoblasts.
Alkaline Phosphatase ; Anabolic Agents ; Asian Continental Ancestry Group ; Biological Products ; Bone Diseases, Metabolic ; Bone Resorption ; Cell Proliferation ; Epimedium* ; Humans ; Osteoblasts ; Osteocalcin ; Osteoclasts ; Osteogenesis ; Osteoporosis ; Osteoprotegerin ; RNA, Messenger

STUDY DESIGN: Literature review. OBJECTIVES: To propose possible mechanisms of osteoporotic back pain and its management with antiosteoporotic drugs. SUMMARY OF LITERATURE REVIEW: No general conclusion has yet been reached regarding whether osteoporosis without fractures can cause pain. Instead, only treatments for back pain without osteoporotic spine fractures have been reviewed in the previous literature. Although key studies of antiosteoporotic drugs have not investigated their analgesic efficacy, plausible mechanisms have been suggested. MATERIALS AND METHODS: The analgesic effects of antiosteoporotic agents available in Korea were reviewed. RESULTS: Rather than the long-term use of conventional analgesics or narcotics, antiosteoporotic drugs would be more beneficial because they can enhance bone strength and have fewer side effects. Both anabolic and antiresorptive agents available in Korea have been proven to have an analgesic effect against osteoporotic back pain, with or without fractures. Anabolic agents depend on skeletal effects. Among antiresorptive agents, bisphosphonates have both skeletal and extraskeletal mechanisms for analgesia. Calcitonin and selective estrogen receptor modulators mostly depend on extraskeletal effects. The order of analgesic strength for osteoporotic back pain is teriparatide > bisphosphonate > calcitonin. This implies that the analgesic effect of antiosteoporotic drugs primarily depends on their skeletal effects rather than on their extraskeletal effects. Moreover, because non-fracture osteoporotic pain has been recognized only in the spine, where fractures can occur without a sensible injury, pain may arise from undiscovered spine fractures. CONCLUSIONS: Antiosteoporotic drugs ameliorate osteoporotic back pain. Their analgesic strength is proportional to their fracture prevention efficacy.
Anabolic Agents ; Analgesia ; Analgesics ; Back Pain ; Bone Density Conservation Agents ; Calcitonin ; Diphosphonates ; Korea ; Narcotics ; Osteoporosis ; Selective Estrogen Receptor Modulators ; Spine ; Teriparatide

BACKGROUND: Despite many ongoing, prospective studies on the topic, sepsis still remains one of the main causes of death in hospital. The hormone insulin-like growth factor 1 (IGF-1) has a similar molecular structure to that of insulin. IGF-1 exerts anabolic effects and plays important roles in both normal physiology and pathologic processes. Previous studies have observed low serum IGF-1 level in patients with critical illnesses. Here, we evaluated changes in IGF-1 level based on survival of septic patients. METHODS: We evaluated 140 patients with sepsis and septic shock (21 with sepsis and 119 with septic shock) admitted to the intensive care unit of a university-affiliated hospital in Korea. Serum IGF-1 level was measured on days 0, 1, 3, and 7. Patients with liver disease were excluded from this study. All data were analyzed using SPSS version 20 (SPSS Inc., Chicago, IL, USA). RESULTS: Patients with septic shock had significantly lower serum IGF-1 level on days 1 and 3 than patients without septic shock (p = 0.002 and p = 0.007, respectively). Generally, there was a negative relationship between IGF-1 and serum cortisol levels; however, this relationship was only significant on day 3 (p = 0.029). Furthermore, renin showed significantly negative correlation with IGF-1 on day 3 (p = 0.038). IGF-1 level did not show significant difference between survivors and non-survivors. CONCLUSIONS: Our results showed that IGF-1 was associated with septic shock, and that the IGF-1 axis is severely disrupted in septic patients. Additionally, serum cortisol and renin levels were associated with IGF-1 level.
Anabolic Agents ; Cause of Death ; Critical Illness ; Humans ; Hydrocortisone ; Insulin ; Insulin-Like Growth Factor I ; Intensive Care Units ; Korea ; Liver Diseases ; Molecular Structure ; Pathologic Processes ; Physiology ; Prospective Studies ; Renin ; Sepsis* ; Shock, Septic* ; Survivors

PURPOSE: Atypical femoral fracture (AFF), periprosthetic femoral fracture (PPFF) and femoral nonunion (FNU) are recalcitrant challenges for orthopedic surgeons. Teriparatide (TPTD) had been demonstrated to have anabolic effects on bone in various studies. We postulated that adjuvant TPTD after operation would enhance biologic stimulation for bone formation. We investigated (1) whether the adjuvant TPTD could achieve satisfactory union rate of surgically challenging cases such as displaced AFF, PPFF and FNU; (2) whether the adjuvant TPTD could promote development of abundant callus after surgical fixation; (3) whether the adjuvant TPTD had medically serious adverse effects. MATERIALS AND METHODS: Thirteen patients who agreed to off label use of TPTD in combination of operation were included in this retrospective case series. Median patients' age was 68.7 years, and there were three male and ten female patients. Their diagnoses were nonunion in six patients and acute fracture in seven. Medical records and radiographic images were reviewed. RESULTS: Twelve of thirteen fractures were united both clinically and radiologically within a year after adjuvant TPTD. Union completed radiologically median 5.4 months and clinically 5.7 months after the medication, respectively. Callus appeared abundantly showing median 1.4 of fracture healing response postoperatively. There was no serious adverse reaction of medication other than itching, muscle cramp, or nausea. CONCLUSION: Even appropriate surgical treatment is a mainstay of treatment for AFF, PPFF, and FNU, the current report suggested that adjuvant TPTD combined with stable fixation results in satisfactory outcome for the challenging fractures of femur.
Anabolic Agents ; Bony Callus ; Diagnosis ; Female ; Femoral Fractures* ; Femur ; Fracture Healing ; Humans ; Male ; Medical Records ; Muscle Cramp ; Nausea ; Off-Label Use ; Orthopedics ; Osteogenesis ; Periprosthetic Fractures ; Pruritus ; Retrospective Studies ; Surgeons ; Teriparatide*

The objectives of this article are to review current pharmacologic approaches for the treatment of osteoporosis in Korea. Calcium and vitamin D supplementation are necessary for osteoporotic patients with inadequate calcium intake and low vitamin D nutritional status, which is a risk factor of osteoporosis. Several pharmacologic therapies are available for treatment of osteoporosis. Antiresorptive agents, bisphosphonates, selective estrogen receptor modulators, denosumab, estrogens, and tibolone are the basis of therapy. Antiresorptive medications reduce the rates of bone remodeling. Several drugs have shown their ability to reduce vertebral and/or nonvertebral fractures in patients with osteoporosis. Bisphosphonates that reduced bone loss and fragility are usually the mainstay of the treatment of osteoporosis. The recently registered denosumab shows similar anti-fracture efficacy by neutralizing receptor activator of nuclear factor-κB ligand, however, marked differences in reversibility can be observed between the two drugs. The anabolic agents, teriparatide, stimulates new bone formation, increases bone density, and reduces fractures. Other treatment options such as hormone replacement therapy, tibolone, raloxifene, and bazedoxifene are also reviewed in this article. Pharmacologic treatments of osteoporosis are associated with adverse effects, but the benefits generally far surpass the risks.
Anabolic Agents ; Bone Density ; Bone Density Conservation Agents ; Bone Remodeling ; Calcium ; Denosumab ; Diphosphonates ; Estrogens ; Hormone Replacement Therapy ; Humans ; Korea ; Nutritional Status ; Osteogenesis ; Osteoporosis* ; Raloxifene Hydrochloride ; Risk Factors ; Selective Estrogen Receptor Modulators ; Teriparatide ; Vitamin D

BACKGROUND: Despite many ongoing, prospective studies on the topic, sepsis still remains one of the main causes of death in hospital. The hormone insulin-like growth factor 1 (IGF-1) has a similar molecular structure to that of insulin. IGF-1 exerts anabolic effects and plays important roles in both normal physiology and pathologic processes. Previous studies have observed low serum IGF-1 level in patients with critical illnesses. Here, we evaluated changes in IGF-1 level based on survival of septic patients. METHODS: We evaluated 140 patients with sepsis and septic shock (21 with sepsis and 119 with septic shock) admitted to the intensive care unit of a university-affiliated hospital in Korea. Serum IGF-1 level was measured on days 0, 1, 3, and 7. Patients with liver disease were excluded from this study. All data were analyzed using SPSS version 20 (SPSS Inc., Chicago, IL, USA). RESULTS: Patients with septic shock had significantly lower serum IGF-1 level on days 1 and 3 than patients without septic shock (p = 0.002 and p = 0.007, respectively). Generally, there was a negative relationship between IGF-1 and serum cortisol levels; however, this relationship was only significant on day 3 (p = 0.029). Furthermore, renin showed significantly negative correlation with IGF-1 on day 3 (p = 0.038). IGF-1 level did not show significant difference between survivors and non-survivors. CONCLUSIONS: Our results showed that IGF-1 was associated with septic shock, and that the IGF-1 axis is severely disrupted in septic patients. Additionally, serum cortisol and renin levels were associated with IGF-1 level.
Anabolic Agents ; Cause of Death ; Critical Illness ; Humans ; Hydrocortisone ; Insulin ; Insulin-Like Growth Factor I ; Intensive Care Units ; Korea ; Liver Diseases ; Molecular Structure ; Pathologic Processes ; Physiology ; Prospective Studies ; Renin ; Sepsis ; Shock, Septic ; Survivors

Cancer-related anorexia-cachexia syndrome (CACS) is a hypercatabolic state, characterized by reduced appetite and weight loss due to ongoing loss of skeletal muscle mass and adipose tissue. CACS occurs mainly in patients with advanced cancer; thus, weight loss in CACS is often associated with poor prognosis and decreased survival. A large number of studies have been conducted on various pharmacologic agents for palliation of cancer-related anorexia. The purpose of this article is to review the pre-existing pharmacologic agents used for CACS and to evaluate the evidence from current studies on each pharmacologic agent. First, appetite stimulants such as corticosteroids, progestins, cyproheptadine, and cannabinoid have been shown to be beneficial by improving appetite and helping with weight changes even if they had no effect on survival rate. Several other agents with anti-inflammatory effects (e.g., eicosapentaenoic acid, thalidomide, and melatonin), prokinetic agents (e.g., metoclopramide), anabolic agents (e.g., androgens and growth hormone), antipsychotics (e.g., mirtazapine and olanzapine), and antiemetics have also been studied in patients in CACS; however further investigations would be required to confirm the beneficial effects.
Adipose Tissue ; Adrenal Cortex Hormones ; Anabolic Agents ; Androgens ; Anorexia ; Antiemetics ; Antipsychotic Agents ; Appetite ; Appetite Stimulants ; Cachexia ; Cyproheptadine ; Eicosapentaenoic Acid ; Glucocorticoids ; Humans ; Muscle, Skeletal ; Progestins ; Prognosis ; Survival Rate ; Thalidomide ; Weight Loss