Plasma phthalate levels in pubertal gynecomastia

Durmaz E., ÖZMERT E. N., ERKEKOĞLU Ü. P., Giray B., DERMAN O., Hincal F., ...More

Pediatrics, vol.125, no.1, 2010 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 125 Issue: 1
  • Publication Date: 2010
  • Doi Number: 10.1542/peds.2009-0724
  • Journal Name: Pediatrics
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Keywords: phthalate, di-(2-ethylhexyl)-phthalate, mono-(2-ethylhexyl)-phthalate, endocrine disrupter, puberty, gynecomastia, N-BUTYL PHTHALATE, SEXUAL-DIFFERENTIATION, TESTOSTERONE SYNTHESIS, GENE-EXPRESSION, MALE-RAT, EXPOSURE, DI-(2-ETHYLHEXYL)-PHTHALATE, TAMOXIFEN, DEHP, DI(2-ETHYLHEXYL)PHTHALATE
  • Lokman Hekim University Affiliated: No


OBJECTIVE: Several untoward health effects of phthalates, which are a group of industrial chemicals with many commercial uses including personal-care products and plastic materials, have been defined. The most commonly used, di-(2-ethylhexyl)-phthalate (DEHP), is known to have antiandrogenic or estrogenic effects or both. Mono-(2-ethylhexyl)-phthalate (MEHP) is the main metabolite of DEHP. In this study, we aimed to determine the plasma DEHP and MEHP levels in pubertal gynecomastia cases. PATIENTS AND METHODS: The study group comprised 40 newly diagnosed pubertal gynecomastia cases who were admitted to Hacettepe University Ihsan Doǧramaci Children's Hospital. The control group comprised 21 age-matched children without gynecomastia or other endocrinologic disorder. Plasma DEHP and MEHP levels were measured by using high-performance liquid chromatography. Serum hormone levels were determined in some pubertal gynecomastia cases according to the physician's evaluation. RESULTS: Plasma DEHP and MEHP levels were found to be statistically significantly higher in the pubertal gynecomastia group compared with the control group (P < .001) (DEHP, 4.66 ± 1.58 and 3.09 ± 0.90 μg/mL, respectively [odds ratio: 2.77 (95% confidence interval: 1.48-5.21)]; MEHP, 3.19 ± 1.41 and 1.37 ± 0.36 μg/mL [odds ratio: 24.76 (95% confidence interval: 3.5-172.6)]). There was a statistically significant correlation between plasma DEHP and MEHP levels (r: 0.58; P < .001). In the pubertal gynecomastia group, no correlation could be determined between plasma DEHP and MEHP levels and any of the hormone levels. CONCLUSIONS: DEHP, which has antiandrogenic or estrogenic effects, may be an etiologic factor in pubertal gynecomastia. These results may pioneer larger-scale studies on the etiologic role of DEHP in pubertal gynecomastia. Copyright © 2009 by the American Academy of Pediatrics.