{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T00:41:44Z","timestamp":1793407304351,"version":"4.5.0"},"reference-count":24,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,9,4]],"date-time":"2013-09-04T00:00:00Z","timestamp":1378252800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Cushing's disease (<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>) presents a remarkable preponderance in female gender, with a female\u2010to\u2010male ratio of 3\u20138:1. The aim of this study was to evaluate gender\u2010related differences in the presentation of <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>, as regards: biochemical indices of hypercortisolism; sensitivity of diagnostic tests; clinical features and complications of disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively studied 84 adult patients with <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>, 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 <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> complications, adjusted for potential confounders (age, gonadal status, <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>, urinary free cortisol values).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We observed no differences between males and females as regards age at diagnosis, disease duration and <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>. Men, compared with women, presented higher urinary free cortisol values (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b7001) and <jats:styled-content style=\"fixed-case\">ACTH<\/jats:styled-content> values (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b705). As regards diagnostic tests, men presented a lower <jats:styled-content style=\"fixed-case\">ACTH<\/jats:styled-content> response to <jats:styled-content style=\"fixed-case\">DDAVP<\/jats:styled-content> stimulation (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b705). The pituitary tumour itself was less easily visualized by pituitary <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> in males compared with females (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b705). Furthermore, some complications of disease were more frequent or more severe in men, in particular hypokalaemia (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b705), hypercoagulable state and osteoporosis at lumbar spine (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b701), 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> is less frequent in male patients, in this gender, it presents with more florid clinical manifestations and may imply more diagnostic difficulties.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.12299","type":"journal-article","created":{"date-parts":[[2013,7,27]],"date-time":"2013-07-27T07:35:45Z","timestamp":1374910545000},"page":"403-410","source":"Crossref","is-referenced-by-count":83,"title":["Diagnosis and complications of Cushing's disease: gender\u2010related differences"],"prefix":"10.1111","volume":"80","author":[{"given":"Marialuisa","family":"Zilio","sequence":"first","affiliation":[{"name":"Endocrinology Unit Department of Medicine DIMED University of Padova Padova 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