Department of Endocrinology, Austin Health and University of Melbourne, Australia.
Best Pract Res Clin Endocrinol Metab. 2022 Sep;36(5):101653. doi: 10.1016/j.beem.2022.101653. Epub 2022 Apr 1.
In this review, we discuss the effects on androgens on the haemopoietic system, focussing largely on the effects of testosterone on erythropoiesis. Stimulation of erythropoiesis is one of the most consistent effects of testosterone treatment observed in clinical trials. In men with anaemia this effect can be beneficial. Conversely, erythrocytosis is one of the most common adverse effects of testosterone treatment with a relative risk of 8.14 (95% CI: 1.87-35.40) estimated by a recent meta-analysis of randomised placebo controlled clinical trials. A reduction in haemoglobin is commonly seen in men receiving androgen deprivation therapy for prostate cancer, and in transwomen receiving gender affirming therapy to reduce serum testosterone. While mechanisms by which androgens regulate erythropoiesis are not fully understood, it is likely that effects on erythropoietic progenitor cells and erythropoietin are involved, with secondary effects on iron metabolism. In contrast, whether androgens exert clinically relevant effects on white blood cells and on platelets requires further study.
在这篇综述中，我们讨论了雄激素对造血系统的影响，主要集中在睾酮对红细胞生成的影响上。刺激红细胞生成是临床试验中观察到的睾酮治疗最一致的效果之一。在贫血的男性中，这种效果可能是有益的。相反，红细胞增多症是睾酮治疗最常见的不良反应之一，最近对随机安慰剂对照临床试验的荟萃分析估计其相对风险为 8.14（95%CI：1.87-35.40）。接受前列腺癌去势治疗的男性和接受降低血清睾酮的性别肯定治疗的跨性别女性中，血红蛋白减少很常见。虽然雄激素调节红细胞生成的机制尚未完全阐明，但很可能涉及对红细胞生成祖细胞和促红细胞生成素的影响，以及对铁代谢的继发性影响。相比之下，雄激素是否对白细胞和血小板产生临床相关影响还需要进一步研究。
