Cited by 93Pituitary Gland Disorders and TreatmentsAdrenal and Paraganglionic TumorsNeuroendocrine Tumor Research Advances

Diagnosis and complications of Cushing’s disease: gender-related differences

Zilio, Marialuisa, Barbot, Mattia, Ceccato, Filippo, Camozzi, Valentina, Bilora, Franca, Casonato, Alessandra, Frigo, Anna Chiara, Albiger, Nora +4 more·2014·Clinical Endocrinology

Abstract

OBJECTIVE: Cushing's disease (CD) presents a remarkable preponderance in female gender, with a female-to-male ratio of 3-8:1. The aim of this study was to evaluate gender-related differences in the presentation of CD, as regards: biochemical indices of hypercortisolism; sensitivity of diagnostic tests; clinical features and complications of disease. METHODS: We retrospectively studied 84 adult patients with CD, 67 women and 17 men, evaluated at diagnosis. We compared the features of the disease between the sexes and analysed the effect of gender on CD complications, adjusted for potential confounders (age, gonadal status, BMI, urinary free cortisol values). RESULTS: We observed no differences between males and females as regards age at diagnosis, disease duration and BMI. Men, compared with women, presented higher urinary free cortisol values (P < 0·001) and ACTH values (P < 0·05). As regards diagnostic tests, men presented a lower ACTH response to DDAVP stimulation (P < 0·05). The pituitary tumour itself was less easily visualized by pituitary MRI in males compared with females (P < 0·05). Furthermore, some complications of disease were more frequent or more severe in men, in particular hypokalaemia (P < 0·05), hypercoagulable state and osteoporosis at lumbar spine (P < 0·01), with consequent higher risk of vertebral fractures. Male gender was found to be an independent risk factor for dyslipidaemia, severity of hypertension, lumbar osteoporosis and fractures. CONCLUSIONS: Although CD is less frequent in male patients, in this gender, it presents with more florid clinical manifestations and may imply more diagnostic difficulties.

Integrity signals

Registry

Crossref · 10.1111/cen.12299

Cites

27 of 27 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Authors
Zilio, M., Barbot, M., Ceccato, F., Camozzi, V., Bilora, F., Casonato, A., Frigo, A. C., Albiger, N., Daidone, V., Mazzai, L., Mantero, F., & Scaroni, C.
Affiliations
University of Padua (IT)
Corresponding author
Scaroni, Carla
Venue
Clinical Endocrinology
Publisher
Wiley
Published
2013-09-04
Volume
80
Issue
3
Pages
403-410
ISSN
  • 0300-0664 (ISSN-L)
  • 1365-2265
OpenAlex
W2018412940
Cited by
93
References
26
Citations by year
2026: 12 · 2025: 9 · 2024: 10 · 2023: 12 · 2022: 2 · 2021: 6 · 2020: 9 · 2019: 8 · 2018: 3 · 2017: 7 · 2016: 6 · 2015: 5 · 2014: 3 · 2013: 1
FWCI
3.93
Type
journal article
Language
en
Open access
closed
Locations
  • Clinical Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
  • Padua Research Archive (University of Padova) (submittedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
  • Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
  • Health Sciences › Medicine › Epidemiology › Neuroendocrine Tumor Research Advances
Keywords
Cushing's disease, sex differences, hypercortisolism, urinary free cortisol, ACTH, pituitary MRI, hypokalemia, hypercoagulability, vertebral fractures, dyslipidemia, hypertension, pituitary adenoma
MeSH terms
Adolescent, Adult, Aged, Blood Coagulation Disorders, Cardiovascular Diseases, Female, Humans, Hydrocortisone, Hypokalemia, Male, Middle Aged, Retrospective Studies, Sex Factors, Pituitary ACTH Hypersecretion, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review