Öz
Aim: To investigate hematological parameters in cases with non-obese
premature adrenarche (PA) and to evaluate the correlations between this
parameters and androgen levels
Material and Method: The study was a case-control study and the files of
the patients was analysed retrospectively. Forty-four children with PA aged 6-9
years and their age and sex matched healthy controls (n=45) were included for
the study. Hematological parameters between groups were compared and the
correlations between this parameters and androgen levels were evaluated.
Results: The mean ages of the case (7.61±1) and control (7.42±0.9) groups were
similar (p>0.05). When we compared between case and control groups, mean
erythrocyte count (5.07±0.22, 4.87±0.31; p<0.05), hemoglobin (Hgb) levels
(13.77±0.79, 12.89±0.84; p<0.05), mean corpuscular volume (81.83±3.73,
79.99±3.74; p<0.05) and red cell distribution wide (12.71±1.80, 13.56±0.66;
p<0.05) were different. On the other hand, dehydroepiandrosterone sulfate
level was positively correlated with Hgb levels (r=0.27; p=0.03).
Conclusion: Higher Hgb and erythrocyte levels in cases
with PA may be partially
explained with increased early and accelerated function in the androgen
biosynthetic steps in this patients. Larger comprehensive studies with an increased
number of cases in each group are needed to explore the alterations. early and
accelerated function in the androgen biosynthetic steps.
Anahtar Kelimeler
Premature adrenarche erythrocyte hemoglobin dehydroepiandrosterone sulfate
Kaynakça
- 1. Ghizzoni L, Milani S. The natural history of premature adrenarche. J Pediatr Endocrinol Metab. 2000;13 Suppl 5:1247-1251.
- 2. Voutilainen R, Jaaskelainen J. Premature adrenarche: etiology, clinical findings, and consequences. J Steroid Biochem Mol Biol. 2015;145:226-236.
- 3. Ibanez L, Potau N, Zampolli M, Street ME, Carrascosa A. Girls diagnosed with premature pubarche show an exaggerated ovarian androgen synthesis from the early stages of puberty: evidence from gonadotropin-releasing hormone agonist testing. Fertil Steril. 1997;67:849-855.
- 4. Claustres M, Sultan C. Androgen and erythropoiesis: evidence for an androgen receptor in erythroblasts from human bone marrow cultures. Horm Res. 1988;29:17-22.
- 5. Moriyama Y, Fisher JW. Effects of testosterone and erythropoietin on erythroid colony formation in human bone marrow cultures. Blood. 1975;45:665-670.
- 6. Udupa KB, Crabtree HM, Lipschitz DA. In vitro culture of proerythroblasts: characterization of proliferative response to erythropoietin and steroids. Br J Haematol. 1986;62:705-714.
- 7. Utriainen P, Jaaskelainen J, Voutilainen R. Blood erythrocyte and hemoglobin concentrations in premature adrenarche. J Clin Endocrinol Metab. 2013;98:E87-E91.
- 8. Bundak R, Furman A, Gunoz H, Darendeliler F, Bas F, Neyzi O. Body mass index references for Turkish children. Acta Paediatr. 2006;95:194-198.
- 9. Shahani S, Braga-Basaria M, Maggio M, Basaria S. Androgens and erythropoiesis: past and present. J Endocrinol Invest. 2009;32:704-716.
- 10. Yip R, Johnson C, Dallman PR. Age-related changes in laboratory values used in the diagnosis of anemia and iron deficiency. Am J Clin Nutr. 1984;39:427-436.
- 11. Hendler ED, Goffinet JA, Ross S, Longnecker RE, Bakovic V. Controlled study of androgen therapy in anemia of patients on maintenance hemodialysis. N Engl J Med. 1974;291:1046-1051.
- 12. Coviello AD, Kaplan B, Lakshman KM, Chen T, Singh AB, Bhasin S. Effects of graded doses of testosterone on erythropoiesis in healthy young and older men. J Clin Endocrinol Metab. 2008;93:914-919.
- 13. Grossmann M, Zajac JD. Hematological changes during androgen deprivation therapy. Asian J Androl. 2012;14:187-192.
- 14. Celik N, Alp H, Camtosun E, Alp E, Celik S, Berk E. The Association between Premature Adrenarche and Cardiovascular Risk May Be Greater than Expected. Horm Res Paediatr. 2017;87:7-14.
- 15. Karunasena N, Han TS, Mallappa A, Elman M, Merke DP, Ross RJ, et al. Androgens correlate with increased erythropoiesis in women with congenital adrenal hyperplasia. Clin Endocrinol (Oxf). 2017;86:19-25.
- 16. Anttila R, Koistinen R, Seppala M, Koistinen H, Siimes MA. Insulin-like growth factor I and insulin-like growth factor binding protein 3 as determinants of blood hemoglobin concentration in healthy subjects. Pediatr Res. 1994;36:745-748.
- 17. Navarro JF, Mora C, Macia M, Garcia J. Randomized prospective comparison between erythropoietin and androgens in CAPD patients. Kidney Int. 2002;61:1537-1544.
- 18. Liimatta J, Utriainen P, Voutilainen R, Jaaskelainen J. Girls with a History of Premature Adrenarche Have Advanced Growth and Pubertal Development at the Age of 12 Years. Front Endocrinol (Lausanne). 2017;8:291.
- 19. Utriainen P, Voutilainen R, Jaaskelainen J. Girls with premature adrenarche have accelerated early childhood growth. J Pediatr. 2009;154:882-887.
- 20. Ibanez L, Diaz R, Lopez-Bermejo A, Marcos MV. Clinical spectrum of premature pubarche: links to metabolic syndrome and ovarian hyperandrogenism. Rev Endocr Metab Disord. 2009;10:63-76.
- 21. Cebeci AN, Tas A. Higher body fat and lower fat-free mass in girls with premature adrenarche. J Clin Res Pediatr Endocrinol. 2015;7:45-48.
- 22. Guven A, Cinaz P, Bideci A. Is premature adrenarche a risk factor for atherogenesis? Pediatr Int. 2005;47:20-25.
- 23. Utriainen P, Jaaskelainen J, Romppanen J, Voutilainen R. Childhood metabolic syndrome and its components in premature adrenarche. J Clin Endocrinol Metab. 2007;92:4282-4285.
- 24. Potau N, Williams R, Ong K, Sanchez-Ufarte C, de ZF, Ibanez L, et al. Fasting insulin sensitivity and post-oral glucose hyperinsulinaemia related to cardiovascular risk factors in adolescents with precocious pubarche. Clin Endocrinol (Oxf). 2003;59:756-762.
- 25. Ibanez L, Potau N, Chacon P, Pascual C, Carrascosa A. Hyperinsulinaemia, dyslipaemia and cardiovascular risk in girls with a history of premature pubarche. Diabetologia. 1998;41:1057-1063.
- 26. Mathew RP, Hernanz-Schulman M, Wang W, Saville B, Bremer A. Changes in carotid artery sonogram in premature adrenarche. J Pediatr Endocrinol Metab. 2012;25:139-145.
- 27. Roldan MB, White C, Witchel SF. Association of the GAA1013-->GAG polymorphism of the insulin-like growth factor-1 receptor (IGF1R) gene with premature pubarche. Fertil Steril. 2007;88:410-417.
- 28. Kang MJ, Lee JS, Kim HY, Jung HW, Lee YA, Lee SH, et al. Contributions of CAG repeat length in the androgen receptor gene and androgen profiles to premature pubarche in Korean girls. Endocr J. 2017;64:91-102.
- 29. Yerges-Armstrong LM, Chai S, O'Connell JR, Curran JE, Blangero J, Mitchell BD, et al. Gene Expression Differences Between Offspring of Long-Lived Individuals and Controls in Candidate Longevity Regions: Evidence for PAPSS2 as a Longevity Gene. J Gerontol A Biol Sci Med Sci. 2016;71:1295-1299.
Öz
Amaç: Obez olmayan prematür adrenarşlı olgularda hematolojik parametreleri
değerlendirmek ve bu parametrelerin androjenlerle olan korelasyonlarını
göstermektir.
Gereç ve Yöntem: Bu çalışma bir vaka kontrol çalışması olup hasta
dosyaları retrospektif olarak araştırıldı. PA tanılı 6-9 yaş arası prepubertal
44 çocuk ile herhangi
bir sistemik hastalığı olmayan yaş ve
cinsiyetleri benzer 45 çocuk çalışmaya dahil edildi. Gruplar arası hemogram
parametreleri karşılaştırıldı, androjen düzeyleri ile olan korelasyonları
değerlendirildi.
Bulgular: Vaka grubunda yaş ortalaması
7,61±1 yıl iken kontrol grubunda 7,42±0,9 idi, (p>0,05). Vaka ve kontrol
grubu karşılaştırıldığında eritrosit sayıları (5,07±0,22, 4,87±0,31;
p<0,05), Hemoglobin düzeyleri (Hgb) (13,77±0,79, 12,89±0,84; p<0,05),
ortalama eritrosit hacmi (81,83±3,73, 79,99±3,74; p<0,05) ve eritrosit
dağılım aralığı (12,71±1,80, 13,56±0,66; p<0,05) farklı idi. Ayrıca
dehidroepiandrosteron-sülfat düzeyi ile Hgb düzeyi arasında pozitif bir
korelasyon vardı (r=0,27; p=0,03).
Sonuç: Prematür
adrenarşlı olgularda
daha yüksek Hgb ve eritrosit düzeyleri bu olgularda görülen androjen biyosentez basamaklarında erken hızlanmış fonksiyonel aktivite
ile ilişkili olabilir. Bu konuda daha geniş vaka serili çalışmalara ihtiyaç
vardır.
Anahtar Kelimeler
Prematür adrenarş hemoglobin eritrosit dehidroepiandrosteron sülfat
Kaynakça
- 1. Ghizzoni L, Milani S. The natural history of premature adrenarche. J Pediatr Endocrinol Metab. 2000;13 Suppl 5:1247-1251.
- 2. Voutilainen R, Jaaskelainen J. Premature adrenarche: etiology, clinical findings, and consequences. J Steroid Biochem Mol Biol. 2015;145:226-236.
- 3. Ibanez L, Potau N, Zampolli M, Street ME, Carrascosa A. Girls diagnosed with premature pubarche show an exaggerated ovarian androgen synthesis from the early stages of puberty: evidence from gonadotropin-releasing hormone agonist testing. Fertil Steril. 1997;67:849-855.
- 4. Claustres M, Sultan C. Androgen and erythropoiesis: evidence for an androgen receptor in erythroblasts from human bone marrow cultures. Horm Res. 1988;29:17-22.
- 5. Moriyama Y, Fisher JW. Effects of testosterone and erythropoietin on erythroid colony formation in human bone marrow cultures. Blood. 1975;45:665-670.
- 6. Udupa KB, Crabtree HM, Lipschitz DA. In vitro culture of proerythroblasts: characterization of proliferative response to erythropoietin and steroids. Br J Haematol. 1986;62:705-714.
- 7. Utriainen P, Jaaskelainen J, Voutilainen R. Blood erythrocyte and hemoglobin concentrations in premature adrenarche. J Clin Endocrinol Metab. 2013;98:E87-E91.
- 8. Bundak R, Furman A, Gunoz H, Darendeliler F, Bas F, Neyzi O. Body mass index references for Turkish children. Acta Paediatr. 2006;95:194-198.
- 9. Shahani S, Braga-Basaria M, Maggio M, Basaria S. Androgens and erythropoiesis: past and present. J Endocrinol Invest. 2009;32:704-716.
- 10. Yip R, Johnson C, Dallman PR. Age-related changes in laboratory values used in the diagnosis of anemia and iron deficiency. Am J Clin Nutr. 1984;39:427-436.
- 11. Hendler ED, Goffinet JA, Ross S, Longnecker RE, Bakovic V. Controlled study of androgen therapy in anemia of patients on maintenance hemodialysis. N Engl J Med. 1974;291:1046-1051.
- 12. Coviello AD, Kaplan B, Lakshman KM, Chen T, Singh AB, Bhasin S. Effects of graded doses of testosterone on erythropoiesis in healthy young and older men. J Clin Endocrinol Metab. 2008;93:914-919.
- 13. Grossmann M, Zajac JD. Hematological changes during androgen deprivation therapy. Asian J Androl. 2012;14:187-192.
- 14. Celik N, Alp H, Camtosun E, Alp E, Celik S, Berk E. The Association between Premature Adrenarche and Cardiovascular Risk May Be Greater than Expected. Horm Res Paediatr. 2017;87:7-14.
- 15. Karunasena N, Han TS, Mallappa A, Elman M, Merke DP, Ross RJ, et al. Androgens correlate with increased erythropoiesis in women with congenital adrenal hyperplasia. Clin Endocrinol (Oxf). 2017;86:19-25.
- 16. Anttila R, Koistinen R, Seppala M, Koistinen H, Siimes MA. Insulin-like growth factor I and insulin-like growth factor binding protein 3 as determinants of blood hemoglobin concentration in healthy subjects. Pediatr Res. 1994;36:745-748.
- 17. Navarro JF, Mora C, Macia M, Garcia J. Randomized prospective comparison between erythropoietin and androgens in CAPD patients. Kidney Int. 2002;61:1537-1544.
- 18. Liimatta J, Utriainen P, Voutilainen R, Jaaskelainen J. Girls with a History of Premature Adrenarche Have Advanced Growth and Pubertal Development at the Age of 12 Years. Front Endocrinol (Lausanne). 2017;8:291.
- 19. Utriainen P, Voutilainen R, Jaaskelainen J. Girls with premature adrenarche have accelerated early childhood growth. J Pediatr. 2009;154:882-887.
- 20. Ibanez L, Diaz R, Lopez-Bermejo A, Marcos MV. Clinical spectrum of premature pubarche: links to metabolic syndrome and ovarian hyperandrogenism. Rev Endocr Metab Disord. 2009;10:63-76.
- 21. Cebeci AN, Tas A. Higher body fat and lower fat-free mass in girls with premature adrenarche. J Clin Res Pediatr Endocrinol. 2015;7:45-48.
- 22. Guven A, Cinaz P, Bideci A. Is premature adrenarche a risk factor for atherogenesis? Pediatr Int. 2005;47:20-25.
- 23. Utriainen P, Jaaskelainen J, Romppanen J, Voutilainen R. Childhood metabolic syndrome and its components in premature adrenarche. J Clin Endocrinol Metab. 2007;92:4282-4285.
- 24. Potau N, Williams R, Ong K, Sanchez-Ufarte C, de ZF, Ibanez L, et al. Fasting insulin sensitivity and post-oral glucose hyperinsulinaemia related to cardiovascular risk factors in adolescents with precocious pubarche. Clin Endocrinol (Oxf). 2003;59:756-762.
- 25. Ibanez L, Potau N, Chacon P, Pascual C, Carrascosa A. Hyperinsulinaemia, dyslipaemia and cardiovascular risk in girls with a history of premature pubarche. Diabetologia. 1998;41:1057-1063.
- 26. Mathew RP, Hernanz-Schulman M, Wang W, Saville B, Bremer A. Changes in carotid artery sonogram in premature adrenarche. J Pediatr Endocrinol Metab. 2012;25:139-145.
- 27. Roldan MB, White C, Witchel SF. Association of the GAA1013-->GAG polymorphism of the insulin-like growth factor-1 receptor (IGF1R) gene with premature pubarche. Fertil Steril. 2007;88:410-417.
- 28. Kang MJ, Lee JS, Kim HY, Jung HW, Lee YA, Lee SH, et al. Contributions of CAG repeat length in the androgen receptor gene and androgen profiles to premature pubarche in Korean girls. Endocr J. 2017;64:91-102.
- 29. Yerges-Armstrong LM, Chai S, O'Connell JR, Curran JE, Blangero J, Mitchell BD, et al. Gene Expression Differences Between Offspring of Long-Lived Individuals and Controls in Candidate Longevity Regions: Evidence for PAPSS2 as a Longevity Gene. J Gerontol A Biol Sci Med Sci. 2016;71:1295-1299.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Eylül 2018 |
| Yayımlandığı Sayı | Yıl 2018 Cilt: 10 Sayı: 3 |
e-ISSN: 2548-0251
The content of this site is intended for health care professionals. All the published articles are distributed under the terms of
Creative Commons Attribution Licence,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.