A longitudinal study of growth, sex steroids and IGF-1 in boys with physiological gynaecomastia

Mikkel G. Mieritz; Lars Lau Raket; Casper P. Hagen; John E. Nielsen; Maj-Lis Møller Talman; Jørgen Holm Petersen; Stefan Horst Sommer; Katharina Maria Main; Niels Jørgensen; Anders Juul

doi:10.1210/jc.2015-2836

A longitudinal study of growth, sex steroids and IGF-1 in boys with physiological gynaecomastia

Mikkel G. Mieritz, Lars Lau Raket, Casper P. Hagen, John E. Nielsen, Maj-Lis Møller Talman, Jørgen Holm Petersen, Stefan Horst Sommer, Katharina Maria Main, Niels Jørgensen, Anders Juul

19 Citations (Scopus)

Abstract

Context: Physiological gynecomastia is common and affects a large proportion of otherwise healthy adolescent boys. It is thought to be caused by an imbalance between estrogen and testosterone, although this is rarely evident in analyses of serum. Objective: This study aimed to describe the frequency of physiological gynecomastia and to determine possible etiological factors (eg, auxology and serum hormone levels) in a longitudinal setup. Design, Settings, and Participants:Aprospective cohort study of 106 healthy Danish boys (5.8-16.4 years) participated in the longitudinal part of the COPENHAGEN Puberty Study. The boys were examined every 6 months during an 8-year follow-up. Median number of examinations was 10 (2-15). Main outcome measurements: Blood samples were analyzed for FSH, LH, testosterone, estradiol, SHBG, inhibin B, anti-Müllerian hormone, IGF-1, and IGF binding protein-3 by immunoassays. Auxological parameters, pubertal development, and the presence of gynecomastia were evaluated at each visit. Results: Fifty-two of 106 boys (49%) developed gynecomastia, of which 10 (19%) presented with intermittent gynecomastia. Boys with physiological gynecomastia reached peak height velocity at a significantly younger age than boys who did not develop gynecomastia (13.5 versus 13.9 years, P<.027), and they had significantly higher serum levels of IGF-1 (P<.000), estradiol (P=.013), free testosterone (P < .001), and FSH (P = .030) during pubertal transition. However, no differences in serum LH or in the estradiol to testosterone ratio were found. Conclusions: Gynecomastia is frequent in pubertal boys. Increased IGF-1 levelsandpubertalgrowth appear to be associated, whereas changes in estrogen to testosterone ratio seem negligible.

Original language	English
Journal	Journal of Clinical Endocrinology and Metabolism
Volume	100
Issue number	10
Pages (from-to)	3752-3759
Number of pages	8
ISSN	0021-972X
DOIs	https://doi.org/10.1210/jc.2015-2836
Publication status	Published - 1 Oct 2015

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@article{12fa2c4509134eeca58279da9896bd91,

title = "A longitudinal study of growth, sex steroids and IGF-1 in boys with physiological gynaecomastia",

abstract = "Context: Physiological gynecomastia is common and affects a large proportion of otherwise healthy adolescent boys. It is thought to be caused by an imbalance between estrogen and testosterone, although this is rarely evident in analyses of serum. Objective: This study aimed to describe the frequency of physiological gynecomastia and to determine possible etiological factors (eg, auxology and serum hormone levels) in a longitudinal setup. Design, Settings, and Participants:Aprospective cohort study of 106 healthy Danish boys (5.8-16.4 years) participated in the longitudinal part of the COPENHAGEN Puberty Study. The boys were examined every 6 months during an 8-year follow-up. Median number of examinations was 10 (2-15). Main outcome measurements: Blood samples were analyzed for FSH, LH, testosterone, estradiol, SHBG, inhibin B, anti-M{\"u}llerian hormone, IGF-1, and IGF binding protein-3 by immunoassays. Auxological parameters, pubertal development, and the presence of gynecomastia were evaluated at each visit. Results: Fifty-two of 106 boys (49%) developed gynecomastia, of which 10 (19%) presented with intermittent gynecomastia. Boys with physiological gynecomastia reached peak height velocity at a significantly younger age than boys who did not develop gynecomastia (13.5 versus 13.9 years, P<.027), and they had significantly higher serum levels of IGF-1 (P<.000), estradiol (P=.013), free testosterone (P < .001), and FSH (P = .030) during pubertal transition. However, no differences in serum LH or in the estradiol to testosterone ratio were found. Conclusions: Gynecomastia is frequent in pubertal boys. Increased IGF-1 levelsandpubertalgrowth appear to be associated, whereas changes in estrogen to testosterone ratio seem negligible.",

author = "Mieritz, {Mikkel G.} and Raket, {Lars Lau} and Hagen, {Casper P.} and Nielsen, {John E.} and Talman, {Maj-Lis M{\o}ller} and Petersen, {J{\o}rgen Holm} and Sommer, {Stefan Horst} and Main, {Katharina Maria} and Niels J{\o}rgensen and Anders Juul",

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doi = "10.1210/jc.2015-2836",

language = "English",

volume = "100",

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journal = "Journal of Clinical Endocrinology and Metabolism",

issn = "0021-972X",

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T1 - A longitudinal study of growth, sex steroids and IGF-1 in boys with physiological gynaecomastia

AU - Mieritz, Mikkel G.

AU - Raket, Lars Lau

AU - Hagen, Casper P.

AU - Nielsen, John E.

AU - Talman, Maj-Lis Møller

AU - Petersen, Jørgen Holm

AU - Sommer, Stefan Horst

AU - Main, Katharina Maria

AU - Jørgensen, Niels

AU - Juul, Anders

N1 - PMID: 26287961

PY - 2015/10/1

Y1 - 2015/10/1

N2 - Context: Physiological gynecomastia is common and affects a large proportion of otherwise healthy adolescent boys. It is thought to be caused by an imbalance between estrogen and testosterone, although this is rarely evident in analyses of serum. Objective: This study aimed to describe the frequency of physiological gynecomastia and to determine possible etiological factors (eg, auxology and serum hormone levels) in a longitudinal setup. Design, Settings, and Participants:Aprospective cohort study of 106 healthy Danish boys (5.8-16.4 years) participated in the longitudinal part of the COPENHAGEN Puberty Study. The boys were examined every 6 months during an 8-year follow-up. Median number of examinations was 10 (2-15). Main outcome measurements: Blood samples were analyzed for FSH, LH, testosterone, estradiol, SHBG, inhibin B, anti-Müllerian hormone, IGF-1, and IGF binding protein-3 by immunoassays. Auxological parameters, pubertal development, and the presence of gynecomastia were evaluated at each visit. Results: Fifty-two of 106 boys (49%) developed gynecomastia, of which 10 (19%) presented with intermittent gynecomastia. Boys with physiological gynecomastia reached peak height velocity at a significantly younger age than boys who did not develop gynecomastia (13.5 versus 13.9 years, P<.027), and they had significantly higher serum levels of IGF-1 (P<.000), estradiol (P=.013), free testosterone (P < .001), and FSH (P = .030) during pubertal transition. However, no differences in serum LH or in the estradiol to testosterone ratio were found. Conclusions: Gynecomastia is frequent in pubertal boys. Increased IGF-1 levelsandpubertalgrowth appear to be associated, whereas changes in estrogen to testosterone ratio seem negligible.

AB - Context: Physiological gynecomastia is common and affects a large proportion of otherwise healthy adolescent boys. It is thought to be caused by an imbalance between estrogen and testosterone, although this is rarely evident in analyses of serum. Objective: This study aimed to describe the frequency of physiological gynecomastia and to determine possible etiological factors (eg, auxology and serum hormone levels) in a longitudinal setup. Design, Settings, and Participants:Aprospective cohort study of 106 healthy Danish boys (5.8-16.4 years) participated in the longitudinal part of the COPENHAGEN Puberty Study. The boys were examined every 6 months during an 8-year follow-up. Median number of examinations was 10 (2-15). Main outcome measurements: Blood samples were analyzed for FSH, LH, testosterone, estradiol, SHBG, inhibin B, anti-Müllerian hormone, IGF-1, and IGF binding protein-3 by immunoassays. Auxological parameters, pubertal development, and the presence of gynecomastia were evaluated at each visit. Results: Fifty-two of 106 boys (49%) developed gynecomastia, of which 10 (19%) presented with intermittent gynecomastia. Boys with physiological gynecomastia reached peak height velocity at a significantly younger age than boys who did not develop gynecomastia (13.5 versus 13.9 years, P<.027), and they had significantly higher serum levels of IGF-1 (P<.000), estradiol (P=.013), free testosterone (P < .001), and FSH (P = .030) during pubertal transition. However, no differences in serum LH or in the estradiol to testosterone ratio were found. Conclusions: Gynecomastia is frequent in pubertal boys. Increased IGF-1 levelsandpubertalgrowth appear to be associated, whereas changes in estrogen to testosterone ratio seem negligible.

U2 - 10.1210/jc.2015-2836

DO - 10.1210/jc.2015-2836

M3 - Journal article

C2 - 26287961

SN - 0021-972X

VL - 100

SP - 3752

EP - 3759

JO - Journal of Clinical Endocrinology and Metabolism

JF - Journal of Clinical Endocrinology and Metabolism

IS - 10

ER -

A longitudinal study of growth, sex steroids and IGF-1 in boys with physiological gynaecomastia

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