OBJECTIVE: Klinefelter Syndrome (KS) is classically described as characterized by hyperestrogenism, although solid evidence is lacking. This study aims to test the hypothesis that men with KS have higher serum estradiol than normal controls. DESIGN: Meta-analysis of all studies extracted by MEDLINE from 1942 to 31 January 2018. All studies reporting serum estradiol measurement were considered, among them only case-control studies were included in the meta-analysis. METHODS: Meta-analysis was conducted according to the PRISMA statement using RevMan. RESULTS: Out of 4120 articles, 23 case-control studies, 14 case series, and 19 case reports reported data on serum estradiol. A total of 707 KS and 1019 controls were included in the meta-analysis. Serum estradiol was slightly, but significantly higher in KS than controls (mean difference 4.25 pg/mL; CI: 0.41, 8.10 pg/mL; p = 0.030). This difference was lost considering only studies using estradiol assays with good accuracy (5.48 pg/mL, CI: -2.11, 13.07 pg/mL; p = 0.160). Serum testosterone and estradiol/testosterone ratio were significantly lower and higher in KS than controls, respectively. Data from KS case series and case reports confirmed that serum estradiol is within the normal ranges. CONCLUSIONS: Serum estradiol is not increased in KS although slightly higher than controls. However, the meta-analysis that included only studies using a serum estradiol assay with good accuracy showed no difference in serum estradiol between KS and controls. The traditional belief that KS is associated with elevated serum estradiol should be reconsidered. This meta-analysis shows that men with KS have relative hyperestrogenism (increased estradiol/testosterone ratio) compared to controls.

Relative hyperestrogenism in Klinefelter Syndrome: results from a meta-analysis / Santi, D.; De Vincentis, S.; Scaltriti, S.; Rochira, Vincenzo. - In: ENDOCRINE. - ISSN 1559-0100. - 64:2(2019), pp. 209-219. [10.1007/s12020-019-01850-y]

Relative hyperestrogenism in Klinefelter Syndrome: results from a meta-analysis.

D. Santi
Writing – Original Draft Preparation
;
S. De Vincentis
Formal Analysis
;
S. Scaltriti
Data Curation
;
V. Rochira.
Conceptualization
2019

Abstract

OBJECTIVE: Klinefelter Syndrome (KS) is classically described as characterized by hyperestrogenism, although solid evidence is lacking. This study aims to test the hypothesis that men with KS have higher serum estradiol than normal controls. DESIGN: Meta-analysis of all studies extracted by MEDLINE from 1942 to 31 January 2018. All studies reporting serum estradiol measurement were considered, among them only case-control studies were included in the meta-analysis. METHODS: Meta-analysis was conducted according to the PRISMA statement using RevMan. RESULTS: Out of 4120 articles, 23 case-control studies, 14 case series, and 19 case reports reported data on serum estradiol. A total of 707 KS and 1019 controls were included in the meta-analysis. Serum estradiol was slightly, but significantly higher in KS than controls (mean difference 4.25 pg/mL; CI: 0.41, 8.10 pg/mL; p = 0.030). This difference was lost considering only studies using estradiol assays with good accuracy (5.48 pg/mL, CI: -2.11, 13.07 pg/mL; p = 0.160). Serum testosterone and estradiol/testosterone ratio were significantly lower and higher in KS than controls, respectively. Data from KS case series and case reports confirmed that serum estradiol is within the normal ranges. CONCLUSIONS: Serum estradiol is not increased in KS although slightly higher than controls. However, the meta-analysis that included only studies using a serum estradiol assay with good accuracy showed no difference in serum estradiol between KS and controls. The traditional belief that KS is associated with elevated serum estradiol should be reconsidered. This meta-analysis shows that men with KS have relative hyperestrogenism (increased estradiol/testosterone ratio) compared to controls.
2019
30-gen-2019
64
2
209
219
Relative hyperestrogenism in Klinefelter Syndrome: results from a meta-analysis / Santi, D.; De Vincentis, S.; Scaltriti, S.; Rochira, Vincenzo. - In: ENDOCRINE. - ISSN 1559-0100. - 64:2(2019), pp. 209-219. [10.1007/s12020-019-01850-y]
Santi, D.; De Vincentis, S.; Scaltriti, S.; Rochira, Vincenzo
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1175363
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