Relationship Between Haemoglobin and Serum Testosterone in Normal Children and Adolescents and in Boys With Delayed Puberty

Abstract

The concentrations of haemoglobin and of serum testosterone were measured in 215 normal children and adolescents aged 7--20 years, and in 8 boys with constitutional delayed puberty. From the age of 14 years onward haemoglobin and testosterone rose in normal boys and differed significantly from the stable levels observed in prepubertal children and pubertal girls. In the entire series of normal boys (n = 118, age 7--20 years) concentrations of haemoglobin and testosterone were found to be closely correlated (r = 0.73, p less than 0.001). These results provide further evidence for a major role of testosterone in the control of erythropoiesis. Therefore, this correlation suggests the use of serum testosterone determination for the proper selection of haemoglobin reference ranges in boys. The respective reference ranges of haemoglobin corresponding to testosterone levels at 0 and 30 nmol/l were 120.5--148.5 and 143.5--171.5 g/l (95% confidence limits). Boys with delayed puberty were found to have significantly reduced median values of haemoglobin and testosterone for their chronological age, and 6 of the 8 boys investigated were truly anaemic on this background. Nevertheless, their haemoglobin concentration did appear appropriate as judged from their testosterone levels. This observation supports the idea that the selection of the relevant reference range for haemoglobin in boys should depend on the state of physical development as expressed by serum testosterone.

Laboratory Reference Intervals in Africa

“…These gender differences in RBC parameters as illustrated in our findings (Table 2), are consistent with previously established evidence that males have higher values than females for these parameters and is partly attributed to the influence of the androgen hormone on erythropoiesis [43,44] and to menstrual blood loss in women [16,25,39,42,45]. It has been reported that estrogens lower the Hb through hemodilution while testosterone increases the plasma volume but increases circulating RBC to an even greater extent [46].…”

Low Testosterone Levels and the Risk of Anemia in Older Men and Women

“…Interestingly, boys with delayed puberty have hemoglobin levels similar to those of prepubertal boys and girls, and treatment with testosterone normalizes hemoglobin levels to those observed in the late male puberty. 2,3 These data suggest that testosterone contributes to the 1-to 2-g/dL difference in hemoglobin concentration between adult men and women. If testosterone stimulates erythropoiesis in adults, it is reasonable to hypothesize that a decline in testosterone levels with aging may negatively affect erythropoiesis.…”

Pubertal upregulation of erythropoiesis in boys is determined primarily by androgen

“…26,27 Furthermore, in adult men, temporary withdrawal of sex hormone effects by using GnRH-analogue treatment is associated with a reversible decrease in hemoglobin level. 28 Cross-sectional studies of pubertal boys have shown that hematocrit levels increase as they mature 29 and that the pubertal increase in hemoglobin correlates closely with serum T. 1 The increase in hemoglobin level appears to follow the induction of testosterone secretion with a 5-month delay. 2 These findings suggest that sex hormones play a role in the maintenance of hemoglobin level typical for adult males and that androgens may trigger the pubertal upregulation of erythropoiesis in boys.…”