Endocrine Abstracts

Pubertal gynecomastia is associated with an imbalance between estrogen and androgen action on the breast glandular tissue. It is a common condition presenting at 10-12 years and peaking at 13-14 yrs, followed by involution that is usually complete by 17 yrs. Pathologic entities associated with childhood or adolescence gynecomastia are rare.

The purpose of this study was to evaluate the bone mineral density (BMD grams/cm²) of children with pubertal gynecomastia.

PATIENTS AND METHODS: The study was conducted in 10 children with pubertal gynecomastia aged 12-17, whose average median age and body mass index were 14.05±1.4 years and 26.7±4 kilograms/m²,respectively. Our control group comprised 25 healthy children of the same age. BMD were determined by dual energy X-ray absorptiometry of the lumbar spine(L1-L4). Adolescent boys with gynecomastia were further divided into two groups. Group A consisted of those boys whose glandular tissue diameter was more than 7 cm and Group B of those with a diameter less than 7 cm. Plasma gonadotrophin levels as well as those of prolactin, total testosterone and estradiol were measured.

RESULTS: Mean BMD values of children with gynecomastia (0.879± 0.127 grams/cm²) were insignificantly higher than those of the control group(0.810±0.126 grams/cm²). BMD values of Group A boys (0.922±0.133 grams/cm²) did not differ significantly from those of Group B (0.814±0.09 grams/cm²) and each group had similar BMD values (p>0.05) with those of the control group (0.810±0.126 grams/cm²). Serum levels of FSH, LH, PRL and testosterone were normal except for elevated estradiol (E2) levels(49.9±26.8 picograms per milliliter)

CONCLUSION Our results show that BMD is not significantly altered in boys with gynecomastia, although slightly higher values can be observed, which could be possibly attributed to the accompanying transient hormonal changes. Long term longitudinal studies are needed to evaluate the BMD after regression of gynecomastia.