An Untargeted Urine Metabolomics Approach for Autologous Blood Transfusion Detection

16 Jul 2020

An Untargeted Urine Metabolomics Approach for Autologous Blood Transfusion Detection / Jacob Bejder, Gözde Gürdeniz, Cătălina Cuparencu, Frederikke Hall, Mikkel Gybel-Brask, Andreas Breenfeldt Andersen, Lars Ove Dragsted, Niels H. Secher, Pär I. Johansson, Nikolai Baastrup Nordsborg. - (Medicine & Science in Sports & Exercise (2020) 16 July)

  • PMID: 32694367
  • DOI: 10.1249/MSS.0000000000002442


Abstract

Purpose: Autologous blood transfusion is performance enhancing and prohibited in sport but remains difficult to detect. This study explored the hypothesis that an untargeted urine metabolomics analysis can reveal one or more novel metabolites with high sensitivity and specificity for detection of autologous blood transfusion.

Methods: In a randomized, double-blinded, placebo-controlled, cross-over design, exercise-trained males (n=12) donated 900 ml blood or were sham phlebotomized. After four weeks, RBCs or saline were reinfused. Urine samples were collected before phlebotomy and 2 h, 1, 2, 3, 5 and 10 days after reinfusion and analyzed by UPLC-QTOF-MS. Models of unique metabolites reflecting autologous blood transfusion were attained by partial least squares discriminant analysis.

Results: The strongest model was obtained 2 h after reinfusion with a misclassification error of 6.3% and 98.8% specificity. However, combining only a few of the strongest metabolites selected by this model provided a sensitivity of 100% at days 1 and 2 and 66% at day 3 with 100% specificity. Metabolite identification revealed the presence of secondary di-2-ethylhexyl phtalate metabolites and putatively identified the presence of (iso)caproic acid glucuronide as the strongest candidate biomarker.

Conclusion: Untargeted urine metabolomics revealed several plasticizers as the strongest metabolic pattern for detection of autologous blood transfusion for up to 3 days. Importantly, no other metabolites in urine appear of value for anti-doping purposes.

Athletes using ergogenic and medical sport supplements report more favourable attitudes to doping than non-users

22 Sep 2020

Athletes using ergogenic and medical sport supplements report more favourable attitudes to doping than non-users Philip Hurst, Christopher Ring, Maria Kavussanu. - (Journal of science and medicine in sport (2020) 22 September)

  • PMID: 32998850
  • DOI: 10.1016/j.jsams.2020.09.012


Abstract

Objectives: Our study objectives were twofold: 1) examine whether users and non-users of different types of sport supplements vary in doping attitudes and sport supplement beliefs, and 2) determine whether the type of sport supplement is directly and indirectly (via sport supplement beliefs) related to doping attitudes.

Design: Cross-sectional survey.

Methods: Athletes (N=557; 77% male, mean±standard deviation; age=20.8±4.5 years, training=5.7±4.2h per week, competing=11.1±5.2 years) completed measures of sport supplement use, sport supplement beliefs, and doping attitudes. Sport supplements were classified into: ergogenic, medical, sport food and drinks, and superfoods.

Results: Compared to non-users, users of ergogenic (d=0.31, p<0.01) and medical (d=0.42, p<0.01) sport supplements reported more favourable attitudes towards doping. In addition, compared to non-users, users of ergogenic (d=1.10, p<0.01), medical (d=0.80, p<0.01) and sport food/drink (d=0.58, p<0.01) supplements reported stronger beliefs in the effectiveness of sport supplements to improve sport performance. Use of ergogenic, medical and sport food/drink supplements was indirectly related to doping attitudes via sport supplement beliefs.

Conclusions: Researchers examining the relationship between sport supplement use and doping should differentiate between sport supplement types to improve measurement accuracy. Sport practitioners administering ergogenic and medical sport supplements to athletes may need to provide additional anti-doping education to counteract any favourable attitudes towards doping.

Keywords: Drug; Performance-enhancing substances; Sports nutritional sciences; Surveys and questionnaires; World anti-doping agency.

Outline of a typology of men’s use of anabolic androgenic steroids in fitness and strength training environments

6 Nov 2016

Outline of a typology of men’s use of anabolic androgenic steroids in fitness and strength training environments / Ask Vest Christiansen, Anders Schmidt Vinther, Dimitris Liokaftos. - (Drugs: Education, Prevention and Policy 24 (2017) 3; p. 295-305)

  • DOI: 10.1080/09687637.2016.1231173

Abstract

Recent research into the use of anabolic androgenic steroids (AAS) in fitness and strength training environments have revealed great variance in users’ approach to AAS use and more specifically their approach to health risks and desired objectives. However, there have only been few attempts to develop theoretical frameworks directed at conceptualising the variance in AAS use. In this paper, we propose a unified framework in the form of a typology, which concerns men’s general approach to AAS use. The typology is based on sociologist Max Weber’s method on the ideal typology. The work comes out of the authors’ own qualitative empirical research on male AAS users in fitness and strength training environments, but is also related to and draws on the international literature on the subject. The suggested typology consists of four ideal types: the Expert type, the Well-being type, the YOLO type and the Athlete type. The four types are developed around two overarching categories, namely users’ approach to risk and effectiveness. The typology outlines distinct and characteristic approaches to AAS use and can, thus, be employed by researchers as well as health professionals as a heuristic tool for investigation and explanation.

Nandrolone decanoate relieves joint pain in hypogonadal men: a novel prospective pilot study and review of the literature

31 Oct 2019

Nandrolone decanoate relieves joint pain in hypogonadal men : a novel prospective pilot study and review of the literature / Alexander J. Tatem, Levi C. Holland, Jason Kovac, Jonathan A. Beilan, Larry I. Lipshultz. - (Translational Andrology and Urology 9 (2020) Supplement 2 (March); p. S186-S194)

  • PMID: 32257859
  • PMCID: PMC7108994
  • DOI: 10.21037/tau.2019.11.03


Abstract

Testosterone is an archetypal androgenic-anabolic steroid (AAS), while its exogenous administration is considered to be the gold standard for the treatment of male hypogonadism. The benefits are not due to its intrinsic nature alone but are due to the result of its interactions with the androgen receptor (AR). As the management of hypogonadism continues to advance into the modern era, it would be preferable for modern andrologists to have multiple tools at their disposal to influence AR activity. Nandrolone, or 19-nortestosterone, is one such compound. In the following review of the literature, we examine the history, pharmacology, and clinical applications of this medication. We also present the results of our novel pilot study examining the favorable effects of nandrolone on joint pain for hypogonadal men.

Keywords: Nandrolone; andrology; arthritis; hypogonadism; joint pain; testosterone; testosterone

Muscle dysmorphia and self-esteem in former and current users of anabolic-androgenic steroids

25 Dec 2019

Muscle dysmorphia and self-esteem in former and current users of anabolic-androgenic steroids / Charlotte W. Greenway, Clare Price. - (Performance Enhancement & Health 7 (2020) 3-4 (March); p. 1-9)

  • DOI: 10.1016/j.peh.2019.100154

Highlights

  • AAS use within the UK is on the rise.
  • It is estimated that as many as 10 % of male gym-goers in the UK experience Muscle dysmorphia.
  • Low self-esteem leads to AAS use in both current and former users.

An evaluation of UK athletics’ clean sport programme in preventing doping in junior elite athletes

26 Dec 2019

An evaluation of UK athletics’ clean sport programme in preventing doping in junior elite athletes / Philip Hurst, Christopher Ring, Maria Kavussanu. - (Performance Enhancement & Health 7 (2020) 3-4 (March); p. 1-6)

  • DOI: 10.1016/j.peh.2019.100155


Highlights

  • UK Athletics’ Clean Sport programme reduces the risk of unintentional doping.
  • The programme reduces intentional doping in the short term, but not over 3-months.
  • Similar education programmes may need to be strengthened to ensure effects remain.


Abstract

The aim of this study was to evaluate UK Athletics’ Clean Sport programme in preventing unintentional and intentional doping in junior elite athletes. Track and field athletes (N = 202) attended UK Athletics’ Clean Sport programme. This programme delivered information about the World Anti-Doping Agency, drug testing, anti-doping rule violations, use of medications, and risks associated with sport supplements. Participants completed measures related to unintentional (i.e. knowledge of anti-doping rules, intention to use sport supplements, beliefs about sport supplements) and intentional (i.e. doping likelihood, doping moral disengagement) doping at baseline, immediately after the programme, and at 3-month follow-up. Compared to baseline, immediately after the programme, participants had more knowledge about anti-doping rules (mean differences ± SEM = 2.34 ± 0.11; d = 1.40) and lower scores for intention to use supplements (−0.92 ± 0.12; d = 0.44), beliefs about the effectiveness of supplements, (−0.57 ± 0.06; d = 0.45), doping likelihood (−0.16 ± 0.03; d = 0.20), and doping moral disengagement (−0.20 ± 0.04; d = 0.26). At follow-up, knowledge of anti-doping rules (1.94 ± 0.12; d = 1.22), intention to use supplements (−1.26 ± 0.12; d = 0.63), and supplement beliefs (−0.52 ± 0.07; d = 0.42) remained different from baseline, whereas doping likelihood (0.01 ± 0.05; d = 0.01) and moral disengagement (0.13 ± 0.03; d = 0.09) returned to baseline. After attending the programme, participants were less likely to unintentionally dope in the short and medium term and were less likely to intentionally dope in the short term. However, the effects on intentional doping were not maintained after 3-months. These findings suggest that although the programme reduces intentional doping in the short term, it needs to be strengthened to sustain effects in the long term.

Testing conditional superannuation as an anti-doping policy supplement for safeguarding athlete health and welfare

11 Feb 2020

Testing conditional superannuation as an anti-doping policy supplement for safeguarding athlete health and welfare / Liam J.A.Lenten, Aaron C.T. Smith. - (Performance Enhancement & Health 7 (2020) 3-4 (March); p. 1-4)

  • DOI: 10.1016/j.peh.2020.100159


Abstract

Given the significant, adverse health implications associated with performance-enhancing drugs in sport, anti-doping policy represents a pivotal intervention for not only protecting sport’s credibility, but also for safeguarding athletes’ health. However, current World Anti-doping Agency (WADA) policy has proven limited in controlling banned doping. This letter reports on a pilot experimental economics study testing ‘conditional superannuation’ as a novel anti-doping policy. A conditional superannuation policy compels athletes to direct a nominal percentage of their sport-related earnings into a managed fund, and only returned to athletes after a period of retirement. Results demonstrate that the policy outperforms existing penalties such as fines and bans. With sport’s hyper-competitive, commercial values, it remains improbable that an elite sports world will ever fully eliminate drugs. Nevertheless, sport needs regulation to help protect athletes from the health costs that arise from uncontrolled substance use. As existing penalty mechanisms appear to be inadequate for controlling sport doping, this letter recommends further research into conditional superannuation as a supplementary anti-doping policy to assist in safeguarding athlete health and welfare by lowering the incentive to utilize banned substances. The policy may also have applications to further domains of health including hospitals, allied health services, and aged care.

An intervention to optimise coach-created motivational climates and reduce athlete willingness to dope (CoachMADE)

16 Aug 2020

An intervention to optimise coach-created motivational climates and reduce athlete willingness to dope (CoachMADE) : a three-country cluster randomised controlled trial / Nikos Ntoumanis, Eleanor Quested, Laurie Patterson, Stella Kaffe, Susan H. Backhouse, George Pavlidis, Lisa Whitaker, Vassilis Barkoukis, Brendan J. Smith, Helen R. Staff, Daniel F. Gucciardi. - (British Journal of Sports Medicine (2020) 101963; p. 1-8)

  • PMID: 32917672
  • DOI: 10.1136/bjsports-2019-101963


Abstract

Objectives: Coach-centred antidoping education is scarce. We tested the efficacy of a motivationally informed antidoping intervention for coaches, with their athletes' willingness to dope as the primary outcome.

Methods: We delivered a cluster randomised controlled trial in Australia, the UK and Greece. This study was a parallel group, two-condition, superiority trial. Participants were 130 coaches and 919 athletes. Coaches in the intervention group attended two workshops and received supplementary information to support them in adopting a motivationally supportive communication style when discussing doping-related issues with their athletes. Coaches in the control condition attended a standard antidoping workshop that provided up-to-date information on antidoping issues yet excluded any motivation-related content. Assessments of willingness to dope (primary outcome) and other secondary outcomes were taken at baseline, postintervention (3 months) and at a 2-month follow up.

Results: Compared with athletes in the control group, athletes in the intervention group reported greater reductions in willingness to take prohibited substances (effect size g=0.17) and psychological need frustration (g=0.23) at postintervention, and greater increases in antidoping knowledge (g=0.27) at follow-up. Coaches in the intervention group reported at postintervention greater increases in efficacy to create an antidoping culture (g=0.40) and in perceived effectiveness of need supporting behaviours (g=0.45) to deal with doping-related situations. They also reported greater decreases in doping attitudes (g=0.24) and perceived effectiveness of need thwarting behaviours (g=0.35).

Conclusions: Antidoping education programmes should consider incorporating principles of motivation, as these could be beneficial to coaches and their athletes. We offer suggestions to strengthen these programmes, as most of the effects we observed were not sustained at follow-up.

Contextual influences and athlete attitudes to drugs in sport

2 Mar 2010

Contextual influences and athlete attitudes to drugs in sport / Aaron C.T. Smith, Bob Stewart, Sunny Oliver-Bennetts, Sharyn McDonald, Lynley Ingerson, Astair Anderson, Geoff Dickson, Paul Emery, Fiona Graetz. - (Sport Management Review 13 (2010) 3 (August); p. 181-197)

  • DOI: 10.1016/j.smr.2010.01.008

Abstract

This article reports on 11 narrative-based case histories which sought to: (1) uncover the attitudes of players and athletes to drugs in sport, and (2) explore contextual factors influencing the formation of those attitudes as informed by social ecology theory. Overall, participants viewed the use of banned performance-enhancing substances as cheating, ‘hard’ non-performance-enhancing recreational or illicit substances as unwise, legal non-performance-enhancing substances as acceptable, and legal performance-enhancing substances as essential. In short, attitudes were sometimes quite libertarian, and contingent upon first, the legality of the substance, and second, its performance impact. Results also indicated that athletes’ attitudes about drugs were fundamentally shaped by sport's culture. Other significant factors included its commercial scale, closely identifiable others, early experiences and critical incidents of players and athletes, and their level of performance.

Pharmacology of testosterone preparations

1 Jan 2004

Pharmacology of testosterone preparations / H.M. Behre, C. Wang, D.J. Handelsman, E. Nieschlag

  • DOI: https://doi.org/10.1017/CBO9780511545221.015

Published in: Testosterone : Action, Deficiency, Subsitution. - Cambridge University Press, 2004. - (Chapter 14; p. 405-444)

  • ISBN: 9780511545221
  • DOI: https://doi.org/10.1017/CBO9780511545221 


Contents

14.1 Historical development of testosterone therapy
14.2 General considerations
14.3 Pharmacology of testosterone preparations
14.3.1 Oral administration
14.3.1.1 Unmodified testosterone
14.3.1.2 17alpha-methyltestosterone
14.3.1.3 Fluoxymesterone
14.3.1.4 Mesterolone
14.3.1.5 Testosterone undecanoate
14.3.2 Sublingual application
14.3.3 Buccal application
14.3.4 Nasal application
14.3.5 Rectal application
14.3.6 Intramuscular application
14.3.6.1 Testosterone propionate
14.3.6.2 Testosterone enanthate
14.3.6.3 Testosterone cypionate and testosterone cyclohexanecarboxylate
14.3.6.4 Testosterone ester combinations
14.3.6.5 Testosterone buciclate
14.3.6.6 Testosterone undecanoate
14.3.6.7 Testosterone decanoate
14.3.6.8 Testosterone microspheres
14.3.7 Subdermal application
14.3.7.1 Testosterone pellets
14.3.7.2 Testosterone microcapsules
14.3.8 Transdermal application
14.4 Key messages
14.5 References

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