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This Article Full Text Full Text (PDF) All Versions of this Article: 296/6/E1319    most recent 90940.2008v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Gonzales, G. F. Articles by Gonzales-Castañeda, C. PubMed PubMed Citation Articles by Gonzales, G. F. Articles by Gonzales-Castañeda, C.

High serum testosterone levels are associated with excessive erythrocytosis of chronic mountain sickness in men

¹Laboratory of Endocrinology and Reproduction, Faculty of Sciences and Philosophy, "Alberto Cazorla Tálleri"; ²Instituto de Investigaciones de la Altura, Universidad Peruana Cayetano Heredia, Lima, Peru

Submitted 23 November 2008 ; accepted in final form 14 March 2009

Chronic mountain sickness (CMS) is characterized by excessive erythrocytosis (EE) secondary to hypoventilation. Erythropoietin (Epo) and testosterone regulate erythrocyte production. Low thyroid hormone levels are also associated to hypoventilation. Hence, these hormones can play a role in etiopathogeny of EE. The purpose of this study was to elucidate the effect of sexual and thyroid hormones and Epo in residents from Lima (150 m) and Cerro de Pasco (4,340 m), Peru, and the response to human chorionic gonadotrophin stimulation (hCG). Three groups, one at low altitude and two at high altitude [1 with hemoglobin values >16–21 g/dl and the second with Hb 21 g/dl (EE)], were studied. hCG was administered intramuscularly in a single dose (1,000 IU), and blood samples were obtained at 0, 6, 12, 24, 48, and 72 h after injection. High-altitude natives present similar levels of gonadotropins and thyroid hormones but lower dehydroepiandrosterone sulphate (DHEAS) levels (P < 0.01) and greater Epo (P < 0.01), 17-hydroxyprogesterone (P < 0.01), and testosterone levels (P < 0.01) than those at 150 m. Serum testosterone levels (524.13 ± 55.91 µg/dl vs. 328.14 ± 53.23 ng/dl, means ± SE; P < 0.05) and testosterone/DHEAS ratios are higher (7.98 ± 1.1 vs. 3.65 ± 1.1; P < 0.01) and DHEAS levels lower in the EE group (83.85 ± 14.60 µg/dl vs. 148.95 ± 19.11 ug/dl; P < 0.05), whereas Epo was not further affected. Testosterone levels were highest and DHEAS levels lowest in the EE group at all times after hCG stimulation. In conclusion, high androgen activity could be involved in the etiopathogeny of CMS. This evidence provides an opportunity to develop new therapeutic strategies.

sex hormones; altitude; estradiol; dehydroepiandrosterone sulfate