Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2024 Jan-Feb;44(1):55-65.
doi: 10.5144/0256-4947.2024.55. Epub 2024 Feb 1.

Sex-related differences in Cushing's disease: a systematic review and meta-analysis

Basel F Alqeeq  1 , Mohammed Ayyad  2 , Waseem J Almadhoun  1 , Mohammad Aboabdo  1 , Mosheer S Aldahdouh  1 , Mohammed Al-Tawil  3 , Ahmed M Al-Ghazali  1
Affiliations
Meta-Analysis

Sex-related differences in Cushing's disease: a systematic review and meta-analysis

Basel F Alqeeq et al. Ann Saudi Med. 2024 Jan-Feb.

Abstract

Background and objectives: Cushing's disease is a rare endocrine disorder. This review aimed to examine sex-specific differences in Cushing's disease.

Design and settings: A meta-analysis was performed on published articles discussing the gender impact of Cushing's disease.

Methods: A systematic search was conducted to identify studies from Medline, Embase, CENTRAL and Scopus. Nine studies enrolling 1047 patients diagnosed with Cushing's disease were included in this meta-analysis.

Results: Male patients presented at a younger age (MD [mean difference]=-5.43; 95% CI [-5.78, -5.08]; P<.00001) than females. Male patients had a significantly higher prevalence of osteoporosis (RR [risk ratio]=1.75; 95% CI [1.36, 225]; P<.0001) and hypokalemia (RR=1.66; 95% CI [1.27, 2.16]; P=.0002). In addition, males had significantly higher rates of negative magnetic resonance imaging (RR=1.53; 95% CI [1.18, 2.0]; P=.002). No sex difference was observed in the prevalence of diabetes (RR=0.92; 95% CI [0.70, 1.22]); P=.57) and dyslipidemia (RR=1.33; 95% CI [0.88, 2.0]; P=.17).

Conclusion: Cushing's disease has a worse clinical presentation in males and more diagnostic difficulties compared to females.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
PRISMA 2020 flow diagram.
Figure 2.
Figure 2.
Pooled estimates of clinical features. (A) osteoporosis; (B) hypokalemia; (C) hypertension; (D) muscle weakness.
Figure 3.
Figure 3.
Pooled estimate of negative magnetic resonance imaging results at diagnosis.
Figure 4.
Figure 4.
Pooled estimate of disease recurrence after trans-sphenoidal surgery.
Figure 5.
Figure 5.
Funnel plots for key outcomes of this meta-analysis. (A) osteoporosis; (B) hypokalemia.
See this image and copyright information in PMC

References

    1. Newell-Price J, Bertagna X, Grossman AB, Nieman LK.. Cushing's syndrome. Lancet. 2006. May 13;367(9522):1605–17. doi: 10.1016/S0140-6736(06)68699-6 PMID: 16698415. - DOI - PubMed
    1. Ross EJ, Linch DC.. Cushing's syndrome–killing disease: discriminatory value of signs and symptoms aiding early diagnosis. Lancet. 1982. Sep 18;2(8299):646–9. doi: 10.1016/s0140-6736(82)92749-0 PMID: 6125785. - DOI - PubMed
    1. Nieman LK, Chrousos GP, Kellner C, Spitz IM, Nisula BC, Cutler GB, et al. . Successful treatment of Cushing's syndrome with the glucocorticoid antagonist RU 486. J Clin Endocrinol Metab. 1985. Sep;61(3):536–40. doi: 10.1210/jcem-61-3-536 PMID: 2991327. - DOI - PubMed
    1. Bertagna X, Guignat L, Groussin L, Bertherat J.. Cushing's disease. Best Pract Res Clin Endocrinol Metab. 2009. Oct;23(5):607–23. doi: 10.1016/j.beem.2009.06.001 PMID: 19945026. - DOI - PubMed
    1. Boscaro M, Barzon L, Fallo F, Sonino N.. Cushing's syndrome. Lancet. 2001. Mar 10;357(9258):783–91. doi: 10.1016/S0140-6736(00)04172-6 PMID: 11253984.. - DOI - PubMed

LinkOut - more resources