Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2015) 37 GP03.02 | DOI: 10.1530/endoabs.37.GP.03.02

ECE2015 Guided Posters Adrenal (2) (8 abstracts)

Androgens and erythropoiesis in females: an insight from patients with congenital adrenal hyperplasia

Nayananjani Karunasena , Richard J Ross & Eleni Daniel


Academic Unit of Diabetes, Endocrinology and Metabolism, Department of Human Metabolism, University of Sheffield, Sheffield, UK.


Background: Androgens promote erythropoiesis and have been used for the treatment of anaemia. Furthermore, polycythemia is a known side effect of androgen therapy. In congenital adrenal hyperplasia (CAH), elevated adrenal androgens cause virilisation of female patients. Glucocorticoid treatment reduces androgen levels but there is a difficult balance between excess androgens and suppressed androgens due to excess glucocorticoid treatment.

Aim of study: To investigate the relationship between androgens and erythropoiesis in females with CAH.

Methodology: A retrospective case note review of 63 patients with CAH. Androgen levels and blood counts performed on the same day were collected and analysed in 44 patients; patients with medical conditions known to affect erythropoiesis were excluded.

Results: 44 patients were studied (27 females); mean age was 35.5±13.2 years. In women, there was a positive correlation of testosterone, androstenedione and 17-OHP levels with haemoglobin (Hb) and haematocrit (Hct).

There was a difference in Hb and Hct between patients with high, normal, and low androstenedione levels (ANOVA, P<0.01). Hct, but not Hb was significantly different with high, normal, and low testosterone levels (ANOVA, P<0.01). Post hoc analysis showed mean Hb and Hct levels were significantly different between high and low androstenedione and testosterone subgroups (P=0.001).

Table 1 Correlations of Hb and Hct with androgens and 17-OHP in women.
17-OHPAndrostenedioneTestosterone
Hbr=0.42 (P=0.0069)r=0.4129 (P=0.0012)r=0.4442 (P=0.0028)
Hctr=0.3564 (P=0.024)r=0.4346 (P=0.0006)r=0.3673 (P=0.0154)

Conclusions: There is a positive correlation between adrenal androgens and erythropoiesis in women with CAH. This effect is significant not only at high levels of androgens but also at low levels. Suboptimal control of androgens in this group of patients may increase the risk of polycythemia and anaemia. Use of Hb and Hct as markers of disease control should be investigated in larger populations of CAH women.

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