GYNECOMASTIA AND CIRRHOSIS OF THE LIVER

被引:31
作者
CAVANAUGH, J
NIEWOEHNER, CB
NUTTALL, FQ
机构
[1] VET AFFAIRS MED CTR,ENDOCRINOL METAB & NUTR SECT,MINNEAPOLIS,MN
[2] UNIV MINNESOTA,DEPT MED,MINNEAPOLIS,MN 55455
关键词
D O I
10.1001/archinte.150.3.563
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Hepatic cirrhosis is frequently listed as a cause of gynecomastia. We found previously that in hospitalized men the prevalence of gynecomastia was correlated with body mass index and with age. The mean body mass index and the prevalence of gynecomastia in the cirrhotic subjects (nonedematous) did not differ from those in the overall population. Because more severely cirrhotic subjects with ascites, peripheral edema, or both usually are thin, we examined 18 more severely cirrhotic subjects and 18 nonobese (mean body mass index, 20.9±0.6 kg/m2), age-matched control subjects for the prevalence of palpable gynecomastia. Total testosterone, free testosterone, total estrogen, and estradiol concentrations also were measured. Fifty percent of the control subjects had gynecomastia. Breast tissue diameter was correlated with body mass index. The prevalence of gynecomastia in the cirrhotic subjects was 44%. In these subjects no significant correlation was noted between breast tissue diameter and body mass index, presumably because the body mass index was increased owing to fluid retention. The results could not be accounted for based on medications. Serum free testosterone concentrations were lower in the cirrhotic patients than in the controls (0.11±0.02 vs 0.22±0.03 nmol/L). The total estrogen-free testosterone ratio was higher in cirrhotic patients (10.3±2.5 vs 2.6±0.5), as was the estradiol-free testosterone ratio (2.2±0.7 vs 0.5±0.1). These ratios did not differ significantly in cirrhotic subjects with and without gynecomastia. Therefore, these data indicate that factors other than the estrogen-testosterone ratio are playing a role in the development of gynecomastia in both cirrhotic subjects and controls or that breast tissue sensitivity to an elevated estrogen-testosterone ratio is highly variable.
引用
收藏
页码:563 / 565
页数:3
相关论文
共 19 条
[1]  
ANDERSEN J, 1987, ACTA PATH MICRO IM A, V95, P263
[2]   PITUITARY-TESTICULAR FUNCTION IN PATIENTS WITH ALCOHOLIC CIRRHOSIS OF THE LIVER [J].
BAHNSEN, M ;
GLUUD, C ;
JOHNSEN, SG ;
BENNETT, P ;
SVENSTRUP, S ;
MICIC, S ;
DIETRICHSON, O ;
SVENDSEN, LB ;
BRODTHAGEN, UA .
EUROPEAN JOURNAL OF CLINICAL INVESTIGATION, 1981, 11 (06) :473-479
[3]  
BAKER HWG, 1976, Q J MED, V45, P145
[4]   GYNECOMASTIA AND SEMEN ABNORMALITIES INDUCED BY SPIRONOLACTONE IN NORMAL MEN [J].
CAMINOSTORRES, R ;
MA, L ;
SNYDER, PJ .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1977, 45 (02) :255-260
[5]   CURRENT CONCEPTS - GYNECOMASTIA [J].
CARLSON, HE .
NEW ENGLAND JOURNAL OF MEDICINE, 1980, 303 (14) :795-799
[6]   ESTROGEN-ANDROGEN IMBALANCE IN HEPATIC CIRRHOSIS - STUDIES IN 13 MALE PATIENTS [J].
CHOPRA, IJ ;
TULCHINSKY, D ;
GREENWAY, FL .
ANNALS OF INTERNAL MEDICINE, 1973, 79 (02) :198-203
[7]   SPIRONOLACTONE THERAPY AND GYNECOMASTIA [J].
CLARK, E .
JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1965, 193 (02) :163-&
[8]   TESTOSTERONE IN HUMAN PLASMA [J].
COPPAGE, WS ;
COONER, AE .
NEW ENGLAND JOURNAL OF MEDICINE, 1965, 273 (17) :902-&
[9]  
FRANTZ AG, 1985, WILLIAMS TXB ENDOCRI, P410
[10]   CONVERSION OF ANDROGENS TO ESTROGENS IN CIRRHOSIS OF LIVER [J].
GORDON, GG ;
OLIVO, J ;
RAFII, F ;
SOUTHREN, AL .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1975, 40 (06) :1018-1026