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. Design Cross-validation study Patients 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). Measurements 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.

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Clinical Practice Guidelines are developed to be of assistance to health care professionals by providing guidance and recommendations for particular areas of practice. The Guidelines should not be considered inclusive of all proper approaches or methods, or exclusive of others. The Guidelines cannot guarantee any specific outcome, nor do they establish a standard of care. The Guidelines are not intended to dictate the treatment of a particular patient. Treatment decisions must be made based on the independent judgment of health care providers and each patient's individual circumstances. The Endocrine Society of Sri Lanka makes no warranty, express or implied, regarding the Guidelines and specifically excludes any warranties of merchantability and fitness for a particular use or purpose. The Society shall not be liable for direct, indirect, special, incidental, or consequential damages related to the use of the information contained herein. Endocrine Society of Sri Lanka thanks the Abbott Laboratories for the unrestricted grant to develop and publish the Thyroid Guidelines.

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Disclaimer: Clinical Practice Guidelines are developed to be of assistance to health care professionals by providing guidance and recommendations for particular areas of practice. The Guidelines should not be considered inclusive of all proper approaches or methods, or exclusive of others. The Guidelines cannot guarantee any specific outcome, nor do they establish a standard of care. The Guidelines are not intended to dictate the treatment of a particular patient. Treatment decisions must be made based on the independent judgment of health care providers and each patient's individual circumstances. The Endocrine Society makes no warranty, express or implied, regarding the Guidelines and specifically excludes any warranties of merchantability and fitness for a particular use or purpose. The Society shall not be liable for direct, indirect, special, incidental, or consequential damages related to the use of the information contained herein.