IGF–pregnancy-associated plasma protein-A (PAPP-A)–stanniocalcin axis and androgenic anabolic steroid use in men and women
Authors' conclusion
Illicit AAS use is associated with persistent, sex-specific alterations in the IGF-PAPP-A-STC2 axis, potentially contributing to cardiovascular risk in recreational athletes.
Study context
- Population
- Male and female recreational athletes who were current or former anabolic androgenic steroids (AAS) users and non-users
- Participants
- 80 / 26 / 58
- Exposure
- Active AAS users vs former users vs non-users
- Active AAS usersn = 80
- Former usersn = 26
- Non-usersn = 58reference
- Outcome
- IGF system (IGF-2, IGFBP-3, STC2, PAPP-A)
Methodological detailsage- and sex-matched non-users
- Age- and sex-matched non-users
Main finding
As reported in the abstract
- IGF-2 reduced in active AAS users vs former users
- 36.1%
- IGF-2 reduced in active AAS users vs non-users (P < .001)
- 38.4%
- IGFBP-3 lower in active AAS users vs former users and non-users, respectively (P < .001)
- 13.6% and 35.8%
- STC2 higher in AAS-using men only vs former users (P = .029)
- 24.5%
- STC2 higher in AAS-using men only vs non-users (P < .001)
- 45.7%
Observational data: associations, not effects.
Further findings
Cumulative lifetime AAS exposure
- Associated with IGF-2, IGFBP-3 and STC2 in multivariable models
Association with cardiac measures
- Higher IGF-2 and IGFBP-3 associated with lower LV mass, higher LV ejection fraction and better diastolic function; higher STC2 associated with adverse outcomes
- all P < .05
Original publication
IGF–PAPP-A–stanniocalcin axis and androgenic anabolic steroid use in men and women. Eur J Endocrinol. Published 19 February 2026. doi:10.
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