Blood erythrocyte and hemoglobin concentrations in premature adrenarche

Premature adrenarche (PA) is characterized by an earlier than normal increase in adrenocortical androgen production, and it is associated with increased serum IGF-I concentrations. Both the GH-IGF system and androgens, particularly testosterone, are known to enhance erythropoiesis.

Our objective was to test the hypothesis that blood erythrocyte count and blood hemoglobin (B-Hb) concentration are increased in PA.

Sixty-four prepubertal children (10 boys) with clinically and biochemically defined PA and 62 healthy prepubertal controls (10 boys) participating in our Premature Adrenarche study were examined, and a fasting blood sample was drawn at a university hospital.

We evaluated B-Hb and erythrocyte, thrombocyte, and leukocyte counts and their association with serum dehydroepiandrosterone sulfate (DHEAS), testosterone and IGF-I concentrations.

Children with PA had higher mean blood erythrocyte count (4.74 vs. 4.64 × 10(12)/liter, P = 0.04; significant difference in girls but not in boys) and a tendency toward higher B-Hb (130 vs. 128 g/liter, P = 0.06) than their controls. No difference was observed in leukocyte or thrombocyte counts between the study groups. In linear regression models including age, sex, body mass index SD score, IGF-I, and DHEAS or testosterone, B-Hb was associated with serum DHEAS (P = 0.04), testosterone (P = 0.01), and IGF-I (P ≤ 0.003) concentrations in the entire study cohort and with IGF-I separately in girls (P ≤ 0.02). Similar models showed a significant association of blood erythrocyte count with serum IGF-I concentration (P = 0.003-0.049) but not with DHEAS or testosterone.

Increased erythrocyte count in PA girls suggests that relatively small increases in serum androgen or IGF-I concentrations during adrenarche may associate with enhanced erythropoiesis.