Endocrine aspects of Klinefelter syndrome : Current Opinion in Endocrinology, Diabetes and Obesity (original) (raw)
GROWTH AND DEVELOPMENT: Edited by Lynne L. Levitsky
Endocrinology and Diabetes, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
Correspondence to Maria G. Vogiatzi, MD, Children's Hospital of Philadelphia, Endocrinology and Diabetes, 3401 Civic Center Blvd, Philadelphia, PA 19035, USA. Tel: +1 215 514 3174; e-mail: [email protected]
Current Opinion in Endocrinology & Diabetes and Obesity 26(1):p 60-65, February 2019. | DOI: 10.1097/MED.0000000000000454
Abstract
Purpose of review
Klinefelter syndrome is the most common sex chromosome abnormality in men. Hypogonadism and testicular degeneration are almost universal. Truncal adiposity, metabolic syndrome and low bone mass occur frequently. This review summarizes the most recent advances in the pathogenesis and management of the endocrine abnormalities in Klinefelter syndrome. It is expected that optimal endocrine management will improve outcomes and quality of life in Klinefelter syndrome.
Recent findings
In Klinefelter syndrome, testosterone replacement is routinely prescribed despite lack of evidence on the optimal dose and time for initiation of therapy. Cross-sectional studies have linked hypogonadism to the development of metabolic abnormalities and low bone mass. Testosterone therapy, however, is not consistently associated with improved metabolic and bone outcomes. Increased truncal adiposity and high rates of metabolic syndrome are present in prepubertal children. A randomized trial of oxandrolone in prepubertal boys showed improvement in visual-motor function, socialization and cardiometabolic health. Testicular sperm extraction (TESE) has success rates similar to other causes of nonobstructive azoospermia when performed between 16 and 35 years of age.
Summary
Endocrine care in Klinefelter syndrome should start in childhood and include evaluation of metabolic risk factors and bone health. Further research to guide evidence-based endocrine care is very much needed.
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