May hepatic steatosis be associated with gynecomastia and epicardial fat? A retrospective study of 599 male patients

Objective: There is no study in the literature investigating the association of hepatic steatosis with both gynecomastia and epicardial fat thickness together. We aimed to determine the correlations between hepatic steatosis through liver density, gynecomastia and epicardial fat thickness in patients undergoing CT scans due to suspected COVID-19 symptoms. Methods A total of 599 male patients who underwent chest CT scans due to a presumed diagnosis of COVID-19 in our radiology clinic were included in the study. Patients’ age, diameters of the subareolar glandular tissues of the right and left breasts, the right retroareolar fatty tissue, liver and spleen density, epicardial fat thickness and biochemical parameters were recorded and analyzed. The laboratory analyses were performed according to the standard methods. Results The mean age of the patients was 47.21±15.00 years. The left subareolar tissue thickness and the right retroareolar fatty tissue thickness that are used to indicate the presence of gynecomastia were found to be significantly correlated with liver density in negative direction (r=-.137, p<0.001;r=-.172, p<0.001;respectively). Epicardial fat thickness was statistically significantly correlated with right subareolar tissue thickness (r=.085, p=0.037), left subareolar tissue thickness (r=.101, p=0.014) and right retroareolar fatty tissue thickness (r=.148, p<0.001). Conclusion The results of this study showed that gynecomastia was significantly correlated with both age and hepatic steatosis. Epicardial fat thickness was also associated with liver steatosis. We demonstrated the significant correlations between epicardial fat thickness and gynecomastia for the first time. Nevertheless, our results need to be confirmed by further comprehensive studies.