青春期男性乳房发育症和假性男性乳房发育症患者的性激素谱。

Sex Hormone Profile in Pubertal Boys With Gynecomastia and Pseudogynecomastia.

机构信息

Department of Pediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Hospital for Children and Adolescents Datteln, University of Witten/Herdecke, Datteln, Germany.

Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, University Hospital of Schleswig-Holstein, Campus Kiel/Christian-Albrechts University of Kiel, Kiel, Germany.

出版信息

J Clin Endocrinol Metab. 2020 Apr 1;105(4). doi: 10.1210/clinem/dgaa044.

DOI:10.1210/clinem/dgaa044

PMID:31996898

Abstract

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.

摘要

内容

男性乳房发育症（由腺体成分增生定义）和假性男性乳房发育症（由脂肪组织定义）在青春期男孩中很常见。已经讨论了与性激素和生长激素轴的关系。

目的

本研究的目的是比较男性乳房发育症和假性男性乳房发育症（通过超声分离）男孩之间的性激素、胰岛素样生长因子 1（IGF-1）和胰岛素样生长因子结合蛋白 3（IGFBP-3）。

设计

这是一项观察性研究。

设置

本研究的地点是一个门诊诊所。

参与者

共有 124 名患有乳房增大的青春期男孩（平均年龄 14 ± 2 岁）和 84 名无乳房增大的健康男孩（平均年龄 14 ± 2 岁）参加了这项研究。

干预措施

未进行干预。

主要观察指标

采用液相色谱-串联质谱法测量孕激素、雌二醇（E2）、雌三醇、雌酮、雄烯二酮、睾酮（T）、二氢睾酮等性激素，以及促性腺激素、催乳素、IGF-1 和 IGFBP-3。

结果

86 名男孩患有男性乳房发育症，38 名男孩患有假性男性乳房发育症。在患有男性乳房发育症的男孩中，E2/T 比值（中位数 22，四分位距 [IQR] 8-75）明显高于患有假性男性乳房发育症的男孩（中位数 12，IQR 5-21）或无乳房增大的健康对照组（中位数 18，IQR 6-44），即使调整了睾丸体积后也是如此。患有男性乳房发育症的男孩的 T 浓度明显低于患有假性男性乳房发育症的男孩（中位数 1.8，IQR 0.7-4.2 nM/L）和无乳房增大的健康对照组（中位数 3.1，IQR 0.6-7.6 nM/L）。患有男性乳房发育症的男孩与患有假性男性乳房发育症的男孩在其他性激素、催乳素、IGF-1 或 IGFBP-3 浓度方面没有差异。