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.
Clin Endocrinol (Oxf). 2021 Apr;94(4):583-589. doi: 10.1111/cen.14403. Epub 2021 Jan 2.
Gynaecomastia is frequent in pubertal boys and is regarded as a self-limiting abnormality. However, longitudinal studies proving this hypothesis are scarce.
Longitudinal follow-up study (median 2.4, range 1.0-4.8 years).
The regression of breast diameter was analysed in 31 pubertal boys aged 11.7-16.1 (median 13.2) years with gynaecomastia. Furthermore, weight changes (as BMI-SDS) and pubertal stage, oestradiol [E2], oestriol, oestrone, androstenedione, testosterone [T], dihydrotestosterone, gonadotropins, IGF-1, and IGFBP-3 serum concentrations determined at first clinical presentation were related to breast diameter regression determined by palpation and disappearance of breast glandular tissue in ultrasound in follow-up to identify possible predictors of breast regression.
During the observation period, the breast diameter decreased (in median -1 (interquartile range [IQR] -5 to +1) cm). At follow-up, 6% of boys had no breast enlargement any more, and 65% developed lipomastia. Gynaecomastia was still present in 29%. None of the analysed hormones was related significantly to breast diameter regression or disappearance of breast glandular tissue. In multiple linear regression analyses adjusted for observational period, as well as age and BMI-SDS at first presentation, changes in BMI-SDS (β-coefficient 6.0 ± 2.3, p = .015) but not the E2/T ratio or any other hormone determined at baseline was related to changes in breast diameter.
Breast diameter regression seems not to be predictable by a hormone profile in pubertal boys with gynaecomastia. In pubertal boys presenting with gynaecomastia, conversion to lipomastia of smaller volume is common. The reduction of weight status was the best predictor of breast diameter regression.
青春期男孩的乳房发育很常见，被认为是一种自限性异常。然而，证明这一假设的纵向研究很少。
纵向随访研究（中位数 2.4 年，范围 1.0-4.8 年）。
对 31 名年龄在 11.7-16.1 岁（中位数 13.2 岁）的青春期乳房发育男孩进行乳房直径的回归分析。此外，体重变化（BMI-SDS）和青春期阶段、雌二醇[E2]、雌三醇、雌酮、雄烯二酮、睾丸酮[T]、二氢睾丸酮、促性腺激素、IGF-1 和 IGFBP-3 血清浓度在首次临床就诊时确定，与触诊和超声随访中乳腺腺组织消失时的乳腺直径回归相关，以确定乳腺回归的可能预测因子。
在观察期间，乳房直径减小（中位数为-1cm（四分位距 [IQR] -5 至+1））。在随访中，6%的男孩乳房不再增大，65%的男孩出现脂肪性乳房。29%的男孩仍存在乳房发育。在多元线性回归分析中，调整了观察期、首次就诊时的年龄和 BMI-SDS，BMI-SDS 的变化（β系数 6.0±2.3，p=0.015），而不是 E2/T 比值或基线时确定的任何其他激素，与乳房直径的变化相关。
在青春期乳房发育的男孩中，乳房直径的回归似乎不能通过激素谱来预测。在出现乳房发育的青春期男孩中，体积较小的脂肪性乳房转化很常见。体重状况的降低是乳房直径回归的最佳预测因子。
