Short summary

Cardiovascular effects of supraphysiological treatment with testosterone is not entirely understood, and present knowledge is primarily based on isolated cases. This PhD study intends to bring important prospective cardiovascular health data on subclinical coronary disease and structural heart dysfunction in two groups of androgen users - subjects with an illicit history of AAS doping and transgender males - so that efficient cardiovascular surveillance programs may be established.

Rationale

This PhD study will include samples from two large clinical initiatives that originates from Department of Endocrinology: The Body Identity Clinic (BIC) and Fitness Doping in Denmark (FIDO-DK). The aim of the PhD is to:

1. Perform a cross-sectional study of detailed cardiovascular status in former and current users of AASs (N=100). Primary and secondary outcomes are 1) non- calcified (soft) coronary plaque formation, 2) calcifications in coronaries, aorta and carotids, 3) heart function and structure and 4) risk markers of cardiovascular disease (CVD) (BIC and FIDO-DK).

2. Initiate a nationwide cohort study and biobank of former and current users of AASs in a detailed and focused health examination program on cardiovascular status (FIDO-DK).

3. Perform a prospective observational cohort study in transgender men (N=100) before and after one year of testosterone treatment (BIC).

Description of the cohort

Recreational athletes (males and females ≥18 years of age) with a history of more than 3 months of doping will be recruited by the FIDO-DK (fitness doping in Denmark) study group, and transgender males are enrolled through BIC (body identity clinic). All participants will undergo the same standardized examination program. The first recreational athletes (n=100) and transgender males (n=200) will be examined as a part of a core protocol program.

Data and biological material

Blood samples, PRO, clinical data, cardiac CT, echocardiography

Collaborating researchers and departments

Department of Cardiology

• Axel Diederichsen

Department of Thoracic and Vascular Surgery

• Jes Lindholt