Endokrynol Pol. 2021 Aug 11. doi: 10.5603/EP.a2021.0070. Online ahead of print.
ABSTRACT
BACKGROUND: Gynecomastia (GM) is benign unilateral or bilateral proliferation of the glandular tissue of breast in males. Its development during adolescence is usually considered a physiologic phenomenon and is expected to resolve within months. Sometimes however it is due to pathologic conditions or diseases and it is not uncommon these not to be recognized on time. The present study aims to investigate the causes of prepubertal and pathologic pubertal GM, its association with obesity, age of appearance and whether GM has a psychological impact on boys and adolescents admitted at endocrine department.
MATERIAL AND METHODS: A total of 157 boys and adolescents with GM were included in a cross-sectional retrospective study in a single tertiary center for endocrine diseases. Patients were evaluated by anthropometric measurements, serum hormonal levels and a questionnaire.
RESULTS: For the period 2009-2018 a total of 157 boys and adolescents were diagnosed with GM (76.43 % obese, 3.18%- overweight). Twelve (7.64 %, mean age of GM development -7.53 years) were prepubertal, 5.09%- with primary or secondary testicular damage, 5.73% with hypogonadotropic hypogonadism, 11.48% -with elevated prolactin level and 110 boys (70.06%) with physiologic pubertal GM. A statistically significant difference was found between the age of development of physiologic GM -11.85 years (9.35-16.92) and those due to hypergonadotropic 13.57 years (10-16.25) (p=0.006) and hypogonadotropic 12.77 (10.50-14.0) (p=0.028) hypogonadism. Onset of pubertal GM in normal weight boys was 13.13 years, and in obese/overweight -11.69 years (p <0.001). Eighty four patients (53.5%) confessed a psychological burden of GM, 12.1 % consulted because of its development, in 8.2 % led to cessation of sports and 2.5 % changed their clothes.
CONCLUSIONS: Prepubertal and pubertal GM has a high association with obesity. Excess adipose tissue has an impact on the age of development in both groups. Nearly a quarter of pubertal cases are due to pathologic conditions and those are often diagnosed more than 18 months after the appearance of breast. So although greater number of pubertal GM is physiologic it may be reasonable adolescents to be evaluated within the first 6 months of breast development so not to delay the diagnosis of pathologic ones. Additionally we have found that GM has a complex influence on psychologic state of boys and adolescents.
PMID:34378787 | DOI:10.5603/EP.a2021.0070
