Elevated serum IGF-I, but unaltered sex steroid levels, in healthy boys with pubertal gynaecomastia

Mikkel G Mieritz; Kaspar Sorensen; Lise Aksglaede; Annette Mouritsen; Casper P Hagen; Linda Hilsted; Anna-Maria Andersson; Anders Juul

doi:10.1111/cen.12323

Elevated serum IGF-I, but unaltered sex steroid levels, in healthy boys with pubertal gynaecomastia

Mikkel G Mieritz, Kaspar Sorensen, Lise Aksglaede, Annette Mouritsen, Casper P Hagen, Linda Hilsted, Anna-Maria Andersson, Anders Juul

14 Citations (Scopus)

Abstract

Objective Pubertal gynaecomastia is a very common condition. Although the underlying aetiology is poorly understood, it is generally accepted that excess of oestrogens and deficit of androgens are involved in the pathogenesis. Furthermore, adiposity as well as the GH/IGF-I axis may play a role. In this study, we elucidate the association of adiposity and levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), sex hormone-binding globulin (SHBG), testosterone, oestrogen, IGF-I and IGFBP-3 with the presence of pubertal gynaecomastia in a large cohort of healthy boys. Patients A total of 501 healthy Danish school boys (aged 6·1-19·8 year) from the COPENHAGEN Puberty Study. Measurements Anthropometry and pubertal stages (PH1-6 and G1-5) were evaluated, and the presence of gynaecomastia was assessed. Body fat percentage was calculated by means of four skin folds and impedance. Nonfasting blood samples were analysed for FSH, LH, testosterone, SHBG, oestradiol, IGF-I, IGFBP-3 and prolactin. Results We found that 23% (31/133) of all pubertal boys had gynaecomastia. More specifically, 63% (10/16) of boys in genital stage 4 had gynaecomastia. Boys with gynaecomastia had significantly higher IGF-I levels compared with controls (IGF-I SD-score 0·72 vs -0·037, P < 0·001). This difference was maintained after adjusting for confounders (age and pubertal stage). Sex steroid levels, oestradiol/testosterone ratio or free testosterone were not associated with the presence of gynaecomastia with or without adjustment for confounders. Conclusions IGF-I levels were elevated in healthy boys with pubertal gynaecomastia compared with boys without gynaecomastia, whereas sex steroid levels did not differ. We speculate that the GH-IGF-I axis may be involved in the pathogenesis of pubertal gynaecomastia.

Original language	English
Journal	Clinical Endocrinology
Volume	80
Issue number	5
Pages (from-to)	691-698
Number of pages	8
ISSN	0300-0664
DOIs	https://doi.org/10.1111/cen.12323
Publication status	Published - May 2014

Keywords

Adipose Tissue
Adiposity
Adolescent
Androgens
Anthropometry
Child
Cohort Studies
Denmark
Estradiol
Follicle Stimulating Hormone
Gynecomastia
Humans
Insulin-Like Growth Factor I
Luteinizing Hormone
Male
Prevalence
Steroids
Testosterone
Young Adult

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10.1111/cen.12323

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@article{760be8f587024c64a2509b666bc49e54,

title = "Elevated serum IGF-I, but unaltered sex steroid levels, in healthy boys with pubertal gynaecomastia",

abstract = "Objective Pubertal gynaecomastia is a very common condition. Although the underlying aetiology is poorly understood, it is generally accepted that excess of oestrogens and deficit of androgens are involved in the pathogenesis. Furthermore, adiposity as well as the GH/IGF-I axis may play a role. In this study, we elucidate the association of adiposity and levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), sex hormone-binding globulin (SHBG), testosterone, oestrogen, IGF-I and IGFBP-3 with the presence of pubertal gynaecomastia in a large cohort of healthy boys. Patients A total of 501 healthy Danish school boys (aged 6·1-19·8 year) from the COPENHAGEN Puberty Study. Measurements Anthropometry and pubertal stages (PH1-6 and G1-5) were evaluated, and the presence of gynaecomastia was assessed. Body fat percentage was calculated by means of four skin folds and impedance. Nonfasting blood samples were analysed for FSH, LH, testosterone, SHBG, oestradiol, IGF-I, IGFBP-3 and prolactin. Results We found that 23% (31/133) of all pubertal boys had gynaecomastia. More specifically, 63% (10/16) of boys in genital stage 4 had gynaecomastia. Boys with gynaecomastia had significantly higher IGF-I levels compared with controls (IGF-I SD-score 0·72 vs -0·037, P < 0·001). This difference was maintained after adjusting for confounders (age and pubertal stage). Sex steroid levels, oestradiol/testosterone ratio or free testosterone were not associated with the presence of gynaecomastia with or without adjustment for confounders. Conclusions IGF-I levels were elevated in healthy boys with pubertal gynaecomastia compared with boys without gynaecomastia, whereas sex steroid levels did not differ. We speculate that the GH-IGF-I axis may be involved in the pathogenesis of pubertal gynaecomastia.",

keywords = "Adipose Tissue, Adiposity, Adolescent, Androgens, Anthropometry, Child, Cohort Studies, Denmark, Estradiol, Follicle Stimulating Hormone, Gynecomastia, Humans, Insulin-Like Growth Factor I, Luteinizing Hormone, Male, Prevalence, Steroids, Testosterone, Young Adult",

author = "Mieritz, {Mikkel G} and Kaspar Sorensen and Lise Aksglaede and Annette Mouritsen and Hagen, {Casper P} and Linda Hilsted and Anna-Maria Andersson and Anders Juul",

note = "{\textcopyright} 2013 John Wiley & Sons Ltd.",

year = "2014",

month = may,

doi = "10.1111/cen.12323",

language = "English",

volume = "80",

pages = "691--698",

journal = "Clinical Endocrinology",

issn = "0300-0664",

publisher = "Wiley-Blackwell",

number = "5",

}

TY - JOUR

T1 - Elevated serum IGF-I, but unaltered sex steroid levels, in healthy boys with pubertal gynaecomastia

AU - Mieritz, Mikkel G

AU - Sorensen, Kaspar

AU - Aksglaede, Lise

AU - Mouritsen, Annette

AU - Hagen, Casper P

AU - Hilsted, Linda

AU - Andersson, Anna-Maria

AU - Juul, Anders

PY - 2014/5

Y1 - 2014/5

N2 - Objective Pubertal gynaecomastia is a very common condition. Although the underlying aetiology is poorly understood, it is generally accepted that excess of oestrogens and deficit of androgens are involved in the pathogenesis. Furthermore, adiposity as well as the GH/IGF-I axis may play a role. In this study, we elucidate the association of adiposity and levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), sex hormone-binding globulin (SHBG), testosterone, oestrogen, IGF-I and IGFBP-3 with the presence of pubertal gynaecomastia in a large cohort of healthy boys. Patients A total of 501 healthy Danish school boys (aged 6·1-19·8 year) from the COPENHAGEN Puberty Study. Measurements Anthropometry and pubertal stages (PH1-6 and G1-5) were evaluated, and the presence of gynaecomastia was assessed. Body fat percentage was calculated by means of four skin folds and impedance. Nonfasting blood samples were analysed for FSH, LH, testosterone, SHBG, oestradiol, IGF-I, IGFBP-3 and prolactin. Results We found that 23% (31/133) of all pubertal boys had gynaecomastia. More specifically, 63% (10/16) of boys in genital stage 4 had gynaecomastia. Boys with gynaecomastia had significantly higher IGF-I levels compared with controls (IGF-I SD-score 0·72 vs -0·037, P < 0·001). This difference was maintained after adjusting for confounders (age and pubertal stage). Sex steroid levels, oestradiol/testosterone ratio or free testosterone were not associated with the presence of gynaecomastia with or without adjustment for confounders. Conclusions IGF-I levels were elevated in healthy boys with pubertal gynaecomastia compared with boys without gynaecomastia, whereas sex steroid levels did not differ. We speculate that the GH-IGF-I axis may be involved in the pathogenesis of pubertal gynaecomastia.

AB - Objective Pubertal gynaecomastia is a very common condition. Although the underlying aetiology is poorly understood, it is generally accepted that excess of oestrogens and deficit of androgens are involved in the pathogenesis. Furthermore, adiposity as well as the GH/IGF-I axis may play a role. In this study, we elucidate the association of adiposity and levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), sex hormone-binding globulin (SHBG), testosterone, oestrogen, IGF-I and IGFBP-3 with the presence of pubertal gynaecomastia in a large cohort of healthy boys. Patients A total of 501 healthy Danish school boys (aged 6·1-19·8 year) from the COPENHAGEN Puberty Study. Measurements Anthropometry and pubertal stages (PH1-6 and G1-5) were evaluated, and the presence of gynaecomastia was assessed. Body fat percentage was calculated by means of four skin folds and impedance. Nonfasting blood samples were analysed for FSH, LH, testosterone, SHBG, oestradiol, IGF-I, IGFBP-3 and prolactin. Results We found that 23% (31/133) of all pubertal boys had gynaecomastia. More specifically, 63% (10/16) of boys in genital stage 4 had gynaecomastia. Boys with gynaecomastia had significantly higher IGF-I levels compared with controls (IGF-I SD-score 0·72 vs -0·037, P < 0·001). This difference was maintained after adjusting for confounders (age and pubertal stage). Sex steroid levels, oestradiol/testosterone ratio or free testosterone were not associated with the presence of gynaecomastia with or without adjustment for confounders. Conclusions IGF-I levels were elevated in healthy boys with pubertal gynaecomastia compared with boys without gynaecomastia, whereas sex steroid levels did not differ. We speculate that the GH-IGF-I axis may be involved in the pathogenesis of pubertal gynaecomastia.

KW - Adipose Tissue

KW - Adiposity

KW - Adolescent

KW - Androgens

KW - Anthropometry

KW - Child

KW - Cohort Studies

KW - Denmark

KW - Estradiol

KW - Follicle Stimulating Hormone

KW - Gynecomastia

KW - Humans

KW - Insulin-Like Growth Factor I

KW - Luteinizing Hormone

KW - Male

KW - Prevalence

KW - Steroids

KW - Testosterone

KW - Young Adult

U2 - 10.1111/cen.12323

DO - 10.1111/cen.12323

M3 - Journal article

C2 - 24033660

SN - 0300-0664

VL - 80

SP - 691

EP - 698

JO - Clinical Endocrinology

JF - Clinical Endocrinology

IS - 5

ER -

Elevated serum IGF-I, but unaltered sex steroid levels, in healthy boys with pubertal gynaecomastia

Abstract

Keywords

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