Abdominal Hypertrophy Syndrome: Characteristics and Potential Pathophysiology

Area of Science:

• Endocrinology and Sports Medicine
• Physiology and Pathophysiology

Background:

• Abdominal hypertrophy syndrome, known as Palumboism or steroid gut, affects athletes using growth hormone (GH) and insulin.
• Characterized by significant abdominal enlargement and distension, its exact causes remain unclear.
• This condition is prevalent in the professional bodybuilding community.

Purpose of the Study:

• To conduct a comprehensive literature review on Palumboism.
• To explore the potential pathophysiology and treatment modalities for this condition.
• To identify gaps in current research and lay the groundwork for future clinical and surgical management.

Main Methods:

• A literature review was performed using PubMed and other sources.
• Keywords included 'palumboism,' 'steroid gut,' 'HGH gut,' 'insulin gut,' 'anabolic steroids,' and 'growth hormone.'
• Inclusion criteria focused on studies investigating pathophysiology, clinical presentation, and management; 30 studies were included in the final review.

Main Results:

• No peer-reviewed studies specifically dedicated to Palumboism were found, indicating a significant research deficit.
• Anecdotal evidence suggests prolonged use of high-dose anabolic steroids, particularly human GH and insulin, may contribute to Palumboism.
• Proposed mechanisms include visceral adiposity, organomegaly, and altered collagen synthesis.

Conclusions:

• A comprehensive understanding of Palumboism is lacking due to insufficient research.
• Further studies are essential to elucidate its pathophysiology, establish diagnostic criteria, and explore effective treatment options.
• The review highlights the need for dedicated research into this condition affecting athletes.