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

• Published in: Annals of Saudi medicine Vol. 44; no. 1; pp. 55 - 65
• Main Authors: Alqeeq, Basel F, Ayyad, Mohammed, Almadhoun, Waseem J, Aboabdo, Mohammad, Aldahdouh, Mosheer S, Al-Tawil, Mohammed, Al-Ghazali, Ahmed M
• Format: Journal Article
• Language: English
• Published: Saudi Arabia King Faisal Specialist Hospital and Research Centre 01.01.2024
• Subjects: Female; Humans; Male; Pituitary ACTH Hypersecretion - epidemiology; Review; Sex Factors
• ISSN: 0256-4947; 0975-4466
• DOI: 10.5144/0256-4947.2024.55

Cushing's disease is a rare endocrine disorder. This review aimed to examine sex-specific differences in Cushing's disease. A meta-analysis was performed on published articles discussing the gender impact of Cushing's disease. 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. Male patients presented at a younger age (MD [mean difference]=-5.43; 95% CI [-5.78, -5.08]; <.00001) than females. Male patients had a significantly higher prevalence of osteoporosis (RR [risk ratio]=1.75; 95% CI [1.36, 225]; <.0001) and hypokalemia (RR=1.66; 95% CI [1.27, 2.16]; =.0002). In addition, males had significantly higher rates of negative magnetic resonance imaging (RR=1.53; 95% CI [1.18, 2.0]; =.002). No sex difference was observed in the prevalence of diabetes (RR=0.92; 95% CI [0.70, 1.22]); =.57) and dyslipidemia (RR=1.33; 95% CI [0.88, 2.0]; =.17). Cushing's disease has a worse clinical presentation in males and more diagnostic difficulties compared to females.