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From a clinical perspective, exposure to anabolicandrogenic steroids should be considered in the differential diagnosis of a wide range of conditions affecting physically active young adults, including cardiomyopathy, arrhythmias, infertility, hepatic dysfunction, mood instability, and unexplained endocrine abnormalities

At baseline, 55% were obese based on BMI thresholds and the median Charlson Comorbidity Index was 5 (IQR 4-6) with hypertension (63.1%), hyperlipidemia (50.9%), and diabetes (43.7%) being the most common comorbid conditions

For relative expression analysis, the comparative 2 (Ct) method was applied to normalise IFNG expression to the endogenous EF1A reference and to express modulation as the relative FC to PBS controls