Adolescent gynecomastia is associated with a high incidence of obesity, dysglycemia, and family background of diabetes mellitus

Kulshreshtha, Bindu; Arpita, Arora; Rajesh, Patnaik T; Sameek, Bhattacharya; Dutta, Deep; Sharma, Neeraj; Mohd, Mohsin

doi:10.4103/2230-8210.196022

Cited by 7 publications

(7 citation statements)

References 32 publications

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“…The average age of our patients at the first visit was 13.8±2.6 years and their level of pubic hair development which was at Tanner stage 3 were consistent with previous studies (33,34). On the other hand, about 40% of the study subjects were at more advanced Tanner stages for pubic hair and almost 35% had greater testicular volumes (P4G4) than is usually observed (P3G3) at this age (22).…”

Section: Discussionsupporting

confidence: 91%

“…Rivera et al indicated that there is a correlation between pubertal gynecomastia and higher BMI percentiles. Kulshreshtha et al (34) also reported that most of the patients (64%) with breast enlargement were obese as per Coles criteria. In our study, the subjects had higher BMI values than the general population according to Centers for Disease Control growth charts.…”

Section: Discussionmentioning

confidence: 92%

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Clinical and Biochemical Phenotype of Adolescent Males with Gynecomastia

Lorek

Tobolska-Lorek

Kalina-Faska

et al. 2019

Jcrpe

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Objective:Gynecomastia is defined as a benign proliferation of male breast glandular tissue. Its prevalence during puberty varies between 50-60% and is also common in neonatal and elderly males. It develops mainly due to the disequilibrium between estrogen and androgen activity in breast tissue, where estradiol (E2) binds to estrogen receptors and stimulates ductal and glandular cells. The aim of this work was to investigate the relationship between sex hormone alterations and the natural history of gynecomastia.Methods:Participants in this study were young males referred to an outpatient clinic, between January 2011 and February 2016, with breast enlargement. Thyroid function, liver function, hormone concentrations and tumor markers were measured and anthropometric assessment was conducted.Results:Subjects comprised 93 males, aged 9 to 18 (mean±standard deviation age 13.8±2.6) years. In 63 of 93 (67.7%) the gynecomastia was confirmed and 28 were followed-up for a median period of three months. None of the boys showed any reduction in breast size during follow-up. There was no correlation between body mass index Z-score and breast size. Breast enlargement progressed in nine boys (32.1%). A positive correlation between estrogen to testosterone (E2/TTE) ratio and Tanner B stage (r=0.47; p=0.034) was observed.Conclusion:The E2/TTE ratio may be a helpful tool in diagnosing gynecomastia. Altered E2/TTE ratio might be responsible for a proportion of cases described previously as idiopathic. Additionally, weight loss does not imply reduction of breast size in boys. Nonetheless it should be the first step in the management of prolonged gynecomastia.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 92%

Clinical and Biochemical Phenotype of Adolescent Males with Gynecomastia

Lorek

Tobolska-Lorek

Kalina-Faska

et al. 2019

Jcrpe

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“…The overall high prevalence of IR was consistent with a high prevalence of overweight/obesity. Our observation of an association of idiopathic gynecomastia with overweight/obesity has been reported in other Indian cohorts, albeit in adolescents (Kulshreshtha et al, 2017).…”

Section: Re Sultssupporting

confidence: 82%

The role of steroid receptors, peptides and growth factors in the aetiopathogenesis of idiopathic gynecomastia

et al. 2022

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Idiopathic gynecomastia is a diagnosis of exclusion. We aimed to evaluate the role of steroids, peptides and growth factors in these patients. Those with bilateral idiopathic gynecomastia (n = 29) (Simon's grade IIb or III) who underwent gland excision were evaluated by immunohistochemical techniques using semi‐quantitative grading for oestrogen receptor (ER), progesterone receptor (PR), aromatase, androgen receptor (AR), peptides (IGF‐1, IGF‐2, HER‐2, parathyroid‐hormone related peptide [PTHrP]) and growth factors (EGFR, TGFβ). The cohort comprised 29 patients, with a mean age of 25.3 ± 5.1 years and a mean body mass index of 27.2 ± 2.3 kg/m2. Grade IIb gynecomastia was present in 79.1% and moderate‐to‐severe insulin resistance (HOMA‐IR >3) in 53.7% of patients. ER expression was positive in 100% samples, followed by AR (96.5%), aromatase (96.5%) and PR (93.1%). IGF‐1 was expressed in 86.2% of the cohort, IGF2 in 27.5% and HER‐2 in only two samples, with both showing weak immunoexpression. None of the patients had positive expression of EGFR, TGF‐β or PTHrP. There was no association between immunoexpression and gynecomastia grade. This study demonstrates the predominant role of oestrogen, aromatase and insulin resistance in the aetiopathogenesis of idiopathic gynecomastia and implicates the paracrine hyperestrogenic milieu in its causation as circulating hormones were normal.

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“…Kulshreshtha et al . [ 31 ] also reported that most of the patients (64%) with breast enlargement were obese as per Coles criteria. In our study, the subjects had higher BMI values than the general population in patients with gynaecomastia.…”

Section: Discussionmentioning

confidence: 99%

Clinical features, presentation and hormonal parameters in patients with pubertal gynecomastia

Acharya

2021

J Family Med Prim Care

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Objective: Gynecomastia is benign enlargement of breast in male. It is postulated that its development is primarily due to a mismatch in ratio of oestrogen and androgen at breast tissue. The aim of this study was to highlight the clinical features, presentation and hormonal parameters at the time of consultation. Methods: All adolescent patients who attended endocrinology department with the complaint of breast enlargement were taken into study. We analysed their thyroid function test, oestrogen, testosterone, prolactin, alpha-fetoprotein, follicle-stimulating hormone, luteinizing hormone, beta HCG (human chorionic gonadotropin) and liver function. Clinical features and anthropometry were recorded. Results: Out of 50 patients enrolled, 34 (68%) had bilateral gynaecomastia while 16 patients (32%) had unilateral disease. Mastalgia was seen in 44 patients (88%). Psychological disturbance in the form of depression was seen in 60% of adolescent boys with gynecomastia. Tanner stage B had positive correlation with oestrogen to testosterone (E2/TTE) ratio (r = 0.47; P = 0.034). All other hormonal parameters were normal. Conclusion: Mastalgia was one of the presenting complaints in majority of patients and many had bilateral enlargement. Altered oestrogen to testosterone ratio is altered in majority of patients thus may be reason for pubertal gynecomastia.

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Adolescent gynecomastia is associated with a high incidence of obesity, dysglycemia, and family background of diabetes mellitus

Cited by 7 publications

References 32 publications

Clinical and Biochemical Phenotype of Adolescent Males with Gynecomastia

Clinical and Biochemical Phenotype of Adolescent Males with Gynecomastia

The role of steroid receptors, peptides and growth factors in the aetiopathogenesis of idiopathic gynecomastia

Clinical features, presentation and hormonal parameters in patients with pubertal gynecomastia

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