title: Androgens correlate with increased erythropoiesis in women with congenital adrenal hyperplasia.
abstract: OBJECTIVE
  Hyperandrogenism in congenital adrenal hyperplasia (CAH) provides an in vivo model for exploring the effect of androgens on erythropoiesis in women. We investigated the association of androgens with haemoglobin (Hb) and haematocrit (Hct) in women with CAH.
  
  
  METHODS
  Cross-validation study.
  
  
  METHODS
  Women with CAH from Sheffield Teaching Hospitals, UK (cohort 1, the training set: n = 23) and National Institutes of Health, USA (cohort 2, the validation set: n = 53).
  
  
  METHODS
  Androgens, full blood count and basic biochemistry, all measured on the same day. Demographic and anthropometric data.
  
  
  RESULTS
  Significant age-adjusted correlations (P < 0·001) were observed for Ln testosterone with Hb and Hct in cohorts 1 and 2 (Hb r = 0·712 & 0·524 and Hct r = 0·705 & 0·466), which remained significant after adjustments for CAH status, glucocorticoid treatment dose and serum creatinine. In the combined cohorts, Hb correlated with androstenedione (P = 0·002) and 17-hydroxyprogesterone (P = 0·008). Hb and Hct were significantly higher in cohort 1 than those in cohort 2, while there were no group differences in androgen levels, glucocorticoid treatment dose or body mass index. In both cohorts, women with Hb and Hct in the highest tertile had significantly higher testosterone levels than women with Hb and Hct in the lowest tertile.
  
  
  CONCLUSIONS
  In women with CAH, erythropoiesis may be driven by androgens and could be considered a biomarker for disease control.
authors.affiliation: Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK.
authors.forename: Nayananjani
authors.initials: N
authors.lastname: Karunasena
authors.affiliation: Institute of Cardiovascular Research, Royal Holloway University of London (ICR2UL) and Ashford and St Peter's NHS Foundation Trust, Surrey, UK.
authors.forename: Thang S
authors.initials: TS
authors.lastname: Han
authors.affiliation: National Institutes of Health Clinical Centre, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA.
authors.forename: Ashwini
authors.initials: A
authors.lastname: Mallappa
authors.affiliation: National Institutes of Health Clinical Centre, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA.
authors.forename: Meredith
authors.initials: M
authors.lastname: Elman
authors.affiliation: National Institutes of Health Clinical Centre, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA.
authors.forename: Deborah P
authors.initials: DP
authors.lastname: Merke
authors.affiliation: Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK.
authors.forename: Richard J M
authors.initials: RJ
authors.lastname: Ross
authors.affiliation: Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK.
authors.forename: Eleni
authors.identifier: http://orcid.org/0000-0003-4699-420X
authors.initials: E
authors.lastname: Daniel
mesh_terms: D000312:Adrenal Hyperplasia, Congenital / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D000328:Adult; D004920:Erythropoiesis; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D017588:Hyperandrogenism / Q000097:blood / Q000209:etiology / Q000503:physiopathology; D008875:Middle Aged; D012189:Retrospective Studies; D013739:Testosterone / Q000502:physiology*; D055815:Young Adult
chemical_list: D006454:Hemoglobins; D013739:Testosterone