(P-BC-66) Quantification of Androgens and Corticosteroids in Male Donor Plasma Identifies Demographic and Biologic Factors That Impact Donor Health and Hemolysis in Red Blood Cell Products.

Background/Case Studies: Elevated testosterone levels and testosterone therapy in blood donors have been shown to increase red blood cell (RBC) stress and hemolysis in cold storage and after transfusion. Corticosteroids, such as cortisol and cortisone, may interfere with effective erythropoiesis leading to changes in RBC characteristics and consequently impact survival in storage. The aim of this study was to identify biologic, and demographic correlates of androgen and corticosteroids that impact blood donation practices and hemolysis in RBC products from male donors.

Study

Design/Methods: Plasma samples (n=2357) from male blood donors who participated in NHLBI’s RBC-Omics project were analyzed for total and free (bioavailable) testosterone, androstenedione, cortisol and cortisone. All steroids were quantified by validated HPLC-MS/MS-base­­d assays. Univariable and linear regression multivariable analyses were conducted to determine the associations between the tested hormones and hemolysis or donor demographics including age, body mass index (BMI), ancestry/ethnicity, donation frequency in recent 24 months, and smoking.

Results/Findings: Among the tested hormones, below reference values of total and free testosterone were observed in ∼29% and 36% of the donors, respectively, whereas supraphysiological values were observed in 1.4% and 0.2% of donors. Only a minor portion of donors (2.2%) had non-physiological concentrations of plasma cortisol. In univariable analysis, smoking was positively (p< 0.05) associated with all tested plasma hormones. For example, free testosterone and cortisol levels among smokers were 71.8±39.9 pg/mL and 10.3±4.11 µg/dL vs 63.8±34.1 pg/mL and 9.65±4.05 µg/dL in non-smokers, respectively. Multivariable analyses (Table 1) revealed that storage hemolysis and donation frequency were negatively associated with all tested plasma hormones. Conversely, donor hemoglobin was positively (p< 0.05) associated with all tested hormones. Androgens exhibited the largest number of significant associations with donor demographics (ancestry, BMI, ferritin) and measures of hemolysis.


Conclusions: This study identified biologic and demographic determinants of plasma androgens and corticosteroids in male donors, which may reflect health conditions, such as hypogonadism and inflammation. About a third of the tested donors had sub-physiological testosterone levels, most of whom were of older age ( >50 years). Frequent blood donations may lead to decreased androgen and corticosteroid concentrations in plasma likely due to physiological response to frequent phlebotomy. The variation in plasma androgens had more pronounced effects on measures of hemolysis in RBC units as compared with corticosteroids.