Abstract

What is the central question of this study? To what extent does testosterone influence haemoglobin formation during male puberty? What is the main finding and its importance? In boys, testosterone might be responsible for about 65% of the increase in haemoglobin mass during puberty. The underlying mechanisms are assumed to be twofold: (i) indirectly, mediated by the increase in lean body mass, and (ii) directly by immediate testosterone effects on erythropoiesis. Thereby, an increase in testosterone of 1ng/ml is associated with an increase in haemoglobin mass of ∼65g. These processes are likely to determine endurance performance in adulthood. The amount of haemoglobin during puberty is related to endurance performance in adulthood. During male puberty, testosterone stimulates erythropoiesis and could therefore be used as a marker for later endurance performance. This cross-sectional study aimed to determine the relationship between serum testosterone concentration and haemoglobin mass (Hbmass) in both male and female children and adolescents and to evaluate the possible influences of altitude and training. Three-hundred and thirteen differentially trained boys and girls aged from 9 to 18years and living at altitudes of 1000 and 2600m above sea level entered the study. The stage of sexual maturation was determined according to the classification of Tanner. Testosterone was measured by ELISA. Hbmass was determined by CO-rebreathing. Haemoglobin concentration did not change during maturation in girls and was 11% higher during puberty in boys, while Hbmass was elevated by 33% in Tanner stage V compared to stage II in girls (498 ± 77 vs. 373 ± 88g) and by 95% in boys (832 ± 143 vs. 428 ± 95g). This difference can most likely be attributed to indirect testosterone influences through an increase in lean body mass (LBM) and to direct testosterone effects on erythropoiesis, which increase the Hbmass by ∼65g per 1ng/ml. Altitude and training statuses were not associated with testosterone, but with an increase in Hbmass (altitude by 1.1g/kg LBM, training by 0.8g/kg LBM). Changes in Hbmass are closely related to testosterone levels during male puberty. Further studies will show whether testosterone and Hbmass during childhood and adolescence can be used as diagnostic tools for endurance talents.

Highlights

  • Maximum oxygen uptake as one limiting factor of endurance capacity in adulthood depends to a decisive extent on the total amount of haemoglobin mass (Hbmass; e.g., Schmidt & Prommer, 2010)

  • Testosterone stimulates erythropoiesis and could be used as a marker for later endurance performance. This cross-sectional study aimed to determine the relationship between serum testosterone concentration and haemoglobin mass (Hbmass) in both male and female children and adolescents and to evaluate the possible influences of altitude and training

  • At stage I and II no significant differences in [Hb], Hct, Hbmass and the blood volumes were detected between the sexes while from stages III to V all haematological values were considerably higher in the boys

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Summary

Introduction

Maximum oxygen uptake as one limiting factor of endurance capacity in adulthood depends to a decisive extent on the total amount of haemoglobin mass (Hbmass; e.g., Schmidt & Prommer, 2010) This amount is already predetermined in adolescence and only slightly modified later (Landgraff & Hallén, 2020; Steiner et al, 2019). Testosterone plays a crucial role in the growth of various tissues, and is reflected in a higher lean body mass (LBM) in men than in women It is a well-known fact that testosterone has a dosedependent stimulatory effect on erythropoiesis (Coviello, et al, 2008), the underlying mechanisms are not yet fully understood. The onset of testicular testosterone production is closely related to a subsequent increase in haemoglobin concentration ([Hb]), and the different testosterone concentrations are assumed to be the main reason for the higher [Hb] in men than in women (Handelsman et al, 2018; Hero et al, 2005)

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