A Rare Case Report and Literature Review of Anabolic-Androgenic Steroids (AAS)-Induced Acute Myocardial Infarction

Anabolic-androgenic steroids (AAS) abuse is common in competitive athletes in order to enhance athletic performances. However, AAS abuse is often associated with deleterious side effects including but not limited to cardiovascular diseases, depression, hormonal abnormalities, and cancer. We present a case of a 31-year-old male with a history of Crohn’s disease on infliximab and chronic AAS use who had persistent retrosternal chest pain found to have an acute myocardial infarction (MI) without obvious cardiovascular risk factors.

Step-up therapy with biphasic insulin aspart-70/30--Sapporo 1-2-3 study

The effectiveness of BIAsp 30 step-up therapy in achieving glycemic control in Japanese patients with type 2 diabetes mellitus was investigated. Study subjects were 99 patients with type 2 diabetes mellitus aged over 20 years who were judged to require insulin therapy due to poor glucose control (HbA1c level of > or =7.5%). BIAsp 30 dosage was determined by the patient's attending physician; coadministration of hypotensive agents and antilipemic agents was permitted, but OAD coadministration was limited to patients already receiving such drugs at the start of the study. Patients who did not achieve HbA1c <6.5% after 16+/-5 weeks with QD (Phase 1) were stepped up to BID (Phase 2). If patients still had not achieved HbA1c <6.5% after 16+/-5 weeks with BID, they were stepped up to TID (Phase 3). 55 of the 99 enrolled subjects completed the study and the rates of achievement of HbA1c <6.5% and HbA1c <7.0% were 45.5% and 74.5%, respectively. Of all registered subjects, 5.1% (5/99) achieved HbA1c <6.5% in QD, 19.5% (16/82) in BID, and 20.6% (7/34) in TID. Statistically significant reductions in HbA1c levels were recorded at the conclusion of each phase, with no incidents requiring intervention, indicating that BIAsp 30 step-up therapy is a safe, simple therapy that can be useful in achieving better glycemic control for Japanese patients with type 2 diabetes mellitus.

[Determination of glycosylated albumin and its clinical significance in diabetes mellitus]

Assessment of diabetic glycaemic control by nonenzymatically glycosylated albumin (G-A) was investigated. Serum albumin was purified by affinity chromatography on Affi-Gel Blue. Using the purified serum albumin in normal and diabetic subjects, G-A was estimated by a colorimetric thiobarbituric acid (TBA) method and the results compared with the levels determined using aminophenyl boronic acid (PBA) affinity chromatography. There was an excellent correlation between the levels estimated by TBA method and PBA affinity chromatography method (r = 0.94). The levels of G-A increased in patients with poorly controlled diabetes mellitus compared to normals. There was a significant correlation (r = 0.84) between the G-A and HbA1 levels in 43 normal and 167 diabetic subjects. As an estimate of diabetic glycaemic control by G-A, the correlations between the G-A and mean fasting blood sugar (FBS) levels were studied. There was a higher correlation (r = 0.67) between G-A and the mean FBS within 2 weeks. On starting insulin therapy in 8 juvenile diabetic subjects, there was a different temporal relationship between the FBS, G-A and HbA1 levels. The G-A levels were significantly decreased at 1, 2, 3 and 4 weeks compared to the HbA1 levels. The present results indicate that the G-A may provide a valuable tool for assessing the mean blood sugar levels between shorter intervals, since the turnover of serum albumin is considerably faster than that of HbA1.