The relationship between pubertal gynecomastia, prostate specific antigen, free androgen index, SHBG and sex steroids

Kılıç, Mustafa; Kanbur, Nuray; Derman, Orhan; Akgül, Sinem; Kutluk, Tezer

doi:10.1515/jpem.2011.112

Cited by 9 publications

(20 citation statements)

References 31 publications

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“…found significantly increased BMI and weight in young adult males (19–29 year) with gynaecomastia and also found a significantly larger sum of all skin folds in subjects with gynaecomastia. The link between body size and the development of gynaecomastia is hypothesized to be increased aromatization in adipose tissue causing an androgen‐oestrogen imbalance . Our failure to demonstrate such an imbalance, nevertheless, does not rule out the possibility of a local change in aromatization in the breast tissue in boys with gynaecomastia.…”

Section: Discussionsupporting

confidence: 93%

“…In our population‐based study of healthy school boys and adolescents, we found that 23% of all pubertal boys had gynaecomastia. More specifically, 63% of boys in genital stage 4 had gynaecomastia which is in accordance with the prevalence reported in previous studies which vary from 40% to 60% . Importantly, we found significantly higher IGF‐I levels in boys with gynaecomastia even after adjustment for confounders.…”

Section: Discussionsupporting

confidence: 92%

“…Lee et al . and Kilic et al . did not detect differences in either FSH or LH between boys with and without gynaecomastia.…”

Section: Discussionmentioning

confidence: 82%

“…finding no differences in BMI and height, but in contrast to the findings of Biro et al . who reported significantly lower weight and BMI in boys with gynaecomastia . By contrast, Ersöz et al .…”

Section: Discussionmentioning

confidence: 89%

“…As ductal growth of the breast is stimulated by oestrogens and antagonized by androgens, it is generally accepted that pubertal gynaecomastia is caused by an excess of oestrogens and/or a deficit of androgens . Circulating sex steroid levels are not altered in most cases of pubertal gynaecomastia although abnormal levels of sex steroid precursors as a result of 17‐keto‐steroid reductase deficiency have been reported in subjects with gynaecomastia . However, in the majority of cases, no underlying endocrinopathy can be detected.…”

Section: Introductionmentioning

confidence: 99%

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Elevated serum IGF‐I, but unaltered sex steroid levels, in healthy boys with pubertal gynaecomastia

Mieritz

Sørensen

Aksglæde

et al. 2013

Clinical Endocrinology

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 92%

“…Lee et al . and Kilic et al . did not detect differences in either FSH or LH between boys with and without gynaecomastia.…”

Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Elevated serum IGF‐I, but unaltered sex steroid levels, in healthy boys with pubertal gynaecomastia

Mieritz

Sørensen

Aksglæde

et al. 2013

Clinical Endocrinology

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EAA clinical practice guidelines—gynecomastia evaluation and management

et al. 2019

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Background: Gynecomastia (GM) is a benign proliferation of the glandular tissue of the breast in men. It is a frequent condition with a reported prevalence of 32-65%, depending on the age and the criteria used for definition. GM of infancy and puberty are common, benign conditions resolving spontaneously in the majority of cases. GM of adulthood is more prevalent among the elderly and proper investigation may reveal an underlying pathology in 45-50% of cases. Objectives: The aim was to provide clinical practice guidelines for the evaluation and management of GM. Materials and methods: A literature search of articles in English for the term 'gynecomastia' was conducted. Evidence-based recommendations were developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. Results: A set of five statements and fifteen clinical recommendations was formulated. Conclusions: The purpose of GM assessment should be the detection of underlying pathological conditions, reversible causes (administration/abuse of aggravating substances), and the discrimination from other breast lumps, particularly breast cancer. Assessment should comprise a thorough medical history and physical examination of the breast and genitalia (including testicular ultrasound). A set of laboratory investigations may integrate the evaluation: testosterone (T), estradiol (E2), sex hormone-binding globulin (SHBG), luteinizing hormone (LH), follicular stimulating hormone (FSH), thyroid stimulating hormone (TSH), prolactin, human chorionic gonadotropin (hCG), alpha-fetal protein (AFP), liver and renal function tests. Breast imaging may be used whenever the clinical examination is equivocal. In suspicious lesions, core needle biopsy should be sought directly instead. Watchful waiting is recommended after treatment of underlying pathology or discontinuation of substances associated with GM. T treatment should be offered to men with proven T deficiency. The use of selective estrogen receptor modulators (SERMs), aromatase inhibitors (AIs) and non-aromatizable androgens is not justified in general. Surgical treatment is the therapy of choice for patients with long-lasting GM.

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Sex Hormone Profile in Pubertal Boys With Gynecomastia and Pseudogynecomastia

Reinehr

Kulle

Barth

et al. 2020

The Journal of Clinical Endocrinology &Amp; Metabolism

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Content Gynecomastia (defined by proliferation of glandular elements) and pseudogynecomastia (defined by adipose tissue) are frequent in pubertal boys. An association with sex hormones and the growth hormone axis has been discussed. Objective The objective of this work is to compare sex hormones, insulin-like growth factor 1 (IGF-1), and insulin-like growth factor binding protein 3 (IGFBP-3) between boys with gynecomastia and pseudogynecomastia (separation by ultrasound). Design An observational study was performed. Setting The setting of this study was an outpatient clinic. Participants A total of 124 pubertal boys (mean age 14 ± 2 years) with breast enlargement and 84 healthy boys (mean age 14 ± 2 years) without breast enlargement participated in this study. Interventions No interventions were performed. Main outcome measures Measurements were taken for sex hormones (progesterone, estradiol [E2], estriol, estrone, androstendione, testosterone [T], dihydrotestosterone) measured by liquid chromatography–tandem mass spectrometry, as well as gonadotropins, prolactin, IGF-1, and IGFBP-3. Results Eighty-six boys suffered from gynecomastia and 38 from pseudogynecomastia. In boys with gynecomastia, the E2/T ratio (median 22, interquartile range [IQR] 8-75) was significantly (P < .05) higher compared to boys with pseudogynecomastia (median 12, IQR 5-21) or healthy controls without breast enlargement (median 18, IQR 6-44) even after adjustment for testes volume. T concentrations were significantly (P < .05) lower in boys with gynecomastia (median 1.8, IQR 0.7-4.2 nM/L) compared to boys with pseudogynecomastia (median 4.3, IQR 1.4-6.9 nM/L) or healthy controls without breast enlargement (median 3.1, IQR 0.6-7.6 nM/L). Boys with gynecomastia did not differ from boys with pseudogynecomastia according to other sex hormones, prolactin, IGF-1, or IGFBP-3 concentrations. Conclusions True gynecomastia is characterized by a relative T deficiency to E2 concentrations in contrast to pseudogynecomastia.

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The relationship between pubertal gynecomastia, prostate specific antigen, free androgen index, SHBG and sex steroids

Cited by 9 publications

References 31 publications

Elevated serum IGF‐I, but unaltered sex steroid levels, in healthy boys with pubertal gynaecomastia

Elevated serum IGF‐I, but unaltered sex steroid levels, in healthy boys with pubertal gynaecomastia

EAA clinical practice guidelines—gynecomastia evaluation and management

Sex Hormone Profile in Pubertal Boys With Gynecomastia and Pseudogynecomastia

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