title: Evaluation of breast enlargement in young males and factors associated with gynecomastia and pseudogynecomastia.
abstract: BACKGROUND
  Gynecomastia is defined as a palpable enlargement of the mammary gland in males that is distinguishable from lipomastia. The aim of this study was to assess the prevalence and characteristics of different causes of breast enlargement in young males referred to our tertiary center, and evaluation of the factors associated with gynaecomastia.
  
  
  METHODS
  One hundred thirty-five male recruits aged 20-30 years were enrolled in the study. A control group comprising 32 age-matched healthy individuals aged 20-25 years was also studied.
  
  
  RESULTS
  Idiopathic gynecomastia (IG) was diagnosed in 31 of 135 patients (23%) and Klinefelter' syndrome (KS) was diagnosed in 70 cases (52%). Patients with KS had significantly higher body mass index (BMI) and waist and hip circumference waist/hip ratio than the control group. FSH, LH and SHBG were significantly higher and DHEAS, free testosterone (fT) and total testosterone (tT) were lower in patients with KS than the control group. Anthropometric measurements revealed significant increase in body weight and BMI in patients with IG compared with healthy controls. FSH and LH levels were significantly higher in the patients with IG. Patients with pseudogynecomastia alone were not obese and hypogonadism was observed in 35.1% of patients.
  
  
  CONCLUSIONS
  We concluded that gynaecomastia in young adult males is mostly because of KS or idiopathic in origin. IG seems to be the result of androgen resistance and in part increased aromatization because of increased adiposity. Symptoms or findings for hypogonadism must be evaluated carefully in patients with pseudogynecomastia. We also suggest that the presence of both gynecomastia and azoospermia necessitate further karyotypic analyses for KS.
authors.affiliation: Department of Endocrinology and Metabolism, Gulhane School of Medicine, Gulhane University, Zulfikar sok 28/8 Buyukesat, Etlik, Ankara, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Yazici
authors.forename: M
authors.initials: M
authors.lastname: Sahin
authors.forename: E
authors.initials: E
authors.lastname: Bolu
authors.forename: D E
authors.initials: DE
authors.lastname: Gok
authors.forename: A
authors.initials: A
authors.lastname: Taslipinar
authors.forename: S
authors.initials: S
authors.lastname: Tapan
authors.forename: D
authors.initials: D
authors.lastname: Torun
authors.forename: G
authors.initials: G
authors.lastname: Uckaya
authors.forename: M
authors.initials: M
authors.lastname: Kutlu
mesh_terms: D000328:Adult; D015992:Body Mass Index; D006177:Gynecomastia / Q000097:blood / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007713:Klinefelter Syndrome / Q000453:epidemiology; D008297:Male; D009765:Obesity / Q000453:epidemiology / Q000503:physiopathology; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult