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The use of these substances for performance enhancementparticularly when administered in high doses or complex cycleshas been associated with a wide range of endocrine, metabolic, and cardiovascular disturbances, as well as psychological effects and the potential development of physical and psychological dependence ( 5 Reasons for the use of anabolicandrogenic steroids in amateur sports 5.1 Body image, masculinity, and social determinants A muscular and well-defined physique constitutes an important component of identity and self-esteem for many men ( In amateur sports, AAS use differs fundamentally from professional doping practices, as substances are typically consumed not to enhance competitive performance but to improve physical appearance and obtain social approval ( 5.2 Role of gym culture and social media Social interactions within gym environments may further reinforce AAS use by normalizing or encouraging such behaviours

The diagnosis of 5-oxoprolinase deficiency is established by: Low activity of 5-oxoprolinase in nucleated cells such as leukocytes or cultured skin fibroblasts (5-oxoprolinase is not present in erythrocytes)

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