Red cell 23diphosphoglycerate

Androgens can increase erythrocyte 2,3-diphosphoglycerate levels by enhancing glycolysation (see above). This compound shifts the oxygen saturation curve of

Fig. 9.1 Synopsis of testosterone-induced effects on erythropoiesis. Abbreviations: EPO: erythropoietin, Fe: iron.

hemoglobin to the right, which results in a greater unloading of oxygen in tissue. Placebo controlled trials in men have demonstrated that 2,3-diphosphoglycerate increases markedly and, as a consequence, an increase in oxygen P50 results, leading to enhanced oxygen delivery (Parker et al. 1972). In patients with renal disease being treated with androgens for anemia, a longer survival of erythrocytes, higher levels of 2,3-diphosphoglycerate and corresponding changes in oxygen affinity were observed (Solomon and Hendler 1987). However, in patients with atherosclerosis, no significant changes in oxygen affinity were detectable under testosterone treatment vs. placebo (Bille-Brahe et al. 1976). For a synopsis of androgen effects on erythropoiesis see Figure 9.1.

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