Shi Zi'ang, Xin Minqiang
Department of Aesthetic and Reconstructive Breast Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100144, China.
J Clin Med. 2024 Dec 30;14(1):158. doi: 10.3390/jcm14010158.
Pubertal gynecomastia (PG) is a common condition characterized by the abnormal development and hyperplasia of unilateral or bilateral breast tissue in adolescent males, affecting up to 50% of appropriately aged adolescents and exhibiting rising prevalence over recent years. The etiology of PG is multifaceted, encompassing physiological, pharmacological, and pathological factors. This narrative review synthesizes evidence from a comprehensive selection of peer-reviewed literature, including observational studies, clinical trials, systematic reviews, and case reports, to explore the pivotal role of endocrine hormones in the pathogenesis of PG. Specifically, it examines the effects of follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), estradiol (E2), progesterone (P), prolactin (PRL), growth hormone (GH), insulin-like growth factor-1 (IGF-1), thyroid hormones (T3, T4), parathyroid hormone (PTH), anti-Müllerian hormone (AMH), human chorionic gonadotropin (hCG), and leptin. By synthesizing current insights, this review underscores the intricate hormonal dynamics underlying PG and their implications for diagnosis and treatment. Conclusively, the findings advocate for a personalized approach in the clinical management of PG, with particular emphasis on the hormonal milieu as a cornerstone of therapeutic strategy.
青春期男性乳房肥大症(PG)是一种常见病症,其特征为青春期男性单侧或双侧乳腺组织异常发育及增生,影响多达50%的适龄青少年,且近年来患病率呈上升趋势。PG的病因是多方面的,包括生理、药理和病理因素。本叙述性综述综合了从大量经同行评审的文献中选取的证据,包括观察性研究、临床试验、系统评价和病例报告,以探讨内分泌激素在PG发病机制中的关键作用。具体而言,它研究了促卵泡生成素(FSH)、黄体生成素(LH)、睾酮(T)、雌二醇(E2)、孕酮(P)、催乳素(PRL)、生长激素(GH)、胰岛素样生长因子-1(IGF-1)、甲状腺激素(T3、T4)、甲状旁腺激素(PTH)、抗苗勒管激素(AMH)、人绒毛膜促性腺激素(hCG)和瘦素的作用。通过综合当前的见解,本综述强调了PG背后复杂的激素动态及其对诊断和治疗的影响。总之,研究结果主张在PG的临床管理中采用个性化方法,特别强调激素环境作为治疗策略的基石。