The Prevalence of Anabolic-Androgenic Steroid Misuse in Iranian Athletes: A Systematic Review and Meta-Analysis

Background: Due to widespread abuse of anabolic-androgenic steroids among professional athletes and ama-teur sportsmen and their health-related problems, determining the prevalence and the pattern of anabolic-androgenic steroid misuse at the national level seems to be vital for designing efficient preventive and educa-tional measures. Methods: This systematic review and meta-analysis was conducted via comprehensive searches of the elec-tronic databases including PubMed, MedLine, Scopus, Google Scholar and National Persian Databases includ-ing SID, Magiran, IranDoc (between 1980 and Dec 2019 in English and Persian languages) and also from cita-tions in the selected papers. Overall, 39 articles met the criteria and were included in qualitative and quantitative synthesis. Results: The overall prevalence rate of anabolic-androgenic steroid misuse in the Iranian athletic population was 36.2% (95% confidence interval (CI), 29-43) with significant heterogeneity between studies (I2=99.0%, P<0.001). Prevalence rate of anabolic-androgenic steroid misuse among elite, male and younger athletes was higher (P<0.05). Moreover, prevalence rate of anabolic-androgenic steroid misuse among body-building ath-letes (36.3%) was higher compared to other athletes (30.9%), (P<0.001). Conclusion: Due to the higher prevalence of anabolic-androgenic steroids misuse in Iran compared to global statistics and the potential for serious adverse effects, preventive strategies and policies should be regarded as a real concern for public health.