{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T19:36:04Z","timestamp":1787686564808,"version":"build-2784847793"},"reference-count":37,"publisher":"Bioscientifica","issue":"5","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"vor","delay-in-days":288,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012319","name":"National Center for Global Health and Medicine","doi-asserted-by":"publisher","award":["21A1015, 24A1004"],"award-info":[{"award-number":["21A1015, 24A1004"]}],"id":[{"id":"10.13039\/100012319","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP17ek010922, JP20ek0109352"],"award-info":[{"award-number":["JP17ek010922, JP20ek0109352"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,5,1]]},"abstract":"<jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                    <jats:p\/>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>Adrenal Cushing syndrome (CS) has been rarely studied in recent years in Japan. This study aimed to investigate clinical characteristics and their changes over time in patients with adrenal CS. We analyzed 101 patients with adrenal CS caused by adenoma, dividing them into two groups based on diagnosis period: December 2011\u2013November 2016 (later group, n = 50) and August 2005\u2013November 2011 (earlier group, n = 51). Differences between the groups and comparisons with previous reports were assessed. Patients with subclinical CS were excluded. Adrenal incidentalomas were the most frequent reason for CS diagnosis (34%). Most patients exhibited few specific cushingoid features (2.5 \u00b1 1.3), with moon faces and central obesity being the most common. Compared to earlier reports, specific cushingoid features were less frequent; nonetheless, no significant differences were observed between the earlier and later groups. All patients had midnight and post-dexamethasone suppression test serum cortisol levels exceeding 5 \u03bcg\/dL. No significant differences were found between the groups regarding non-specific symptoms, endocrinological findings related to cortisol secretion, cardiometabolic commodities or infections, except for glucose intolerance and bone complications. The prevalence of metabolic disorders other than glucose intolerance and osteoporosis fluctuated over time. Sixteen patients developed cardiovascular diseases or severe infections. In conclusion, adrenal CS became less florid in the 2000s, showed no improvement in the following years, and remained associated with a high complication rate. Further research is needed to establish an early detection model for CS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Plain language summary<\/jats:title>\n                    <jats:p>Our study found that one-sixth of patients with adrenal Cushing syndrome continued to develop severe complications in this century despite their specific cushingoid features being less pronounced than in the past. Notably, the findings provide clinical insights that may aid in earlier disease diagnosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1530\/ec-24-0684","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T13:33:53Z","timestamp":1745847233000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-10","source":"Crossref","is-referenced-by-count":6,"title":["Changes in clinical features of adrenal Cushing syndrome: a national registry study"],"prefix":"10.1530","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0396-8645","authenticated-orcid":true,"given":"Takuyuki","family":"Katabami","sequence":"first","affiliation":[{"name":"Department of Metabolism and Endocrinology, St. Marianna University Yokohama Seibu Hospital 1 , , ,","place":["Yokohama, Kanagawa, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiko","family":"Asai","sequence":"additional","affiliation":[{"name":"Department of Metabolism and Endocrinology, St. Marianna University School of Medicine 2 , , ,","place":["Kawasaki, Kanagawa, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren","family":"Matsuba","sequence":"additional","affiliation":[{"name":"Department of Metabolism and Endocrinology, St. Marianna University Yokohama Seibu Hospital 1 , , ,","place":["Yokohama, Kanagawa, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0757-7529","authenticated-orcid":true,"given":"Masakatsu","family":"Sone","sequence":"additional","affiliation":[{"name":"Department of Metabolism and Endocrinology, St. Marianna University School of Medicine 2 , , ,","place":["Kawasaki, Kanagawa, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoichiro","family":"Izawa","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Tottori University Faculty of Medicine 3 , , ,","place":["Yonago, Tottori, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takamasa","family":"Ichijo","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology, Saiseikai Yokohama-shi Tobu Hospital 4 , , ,","place":["Yokohama, Kanagawa, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mika","family":"Tsuiki","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center 5 , ,","place":["Kyoto, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shintaro","family":"Okamura","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Tenri Hospital 6 , ,","place":["Nara, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takanobu","family":"Yoshimoto","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology, Tokyo Metropolitan Hiroo Hospital 7 , ,","place":["Tokyo, Japan"]},{"name":"Department of Molecular Endocrinology and Metabolism, Tokyo Medical and Dental University 8 , ,","place":["Tokyo, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michio","family":"Otsuki","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Tokyo Women\u2019s Medical University 9 , ,","place":["Tokyo, Japan"]},{"name":"Department of Metabolic Medicine, Osaka University Graduate School of Medicine 10 , ,","place":["Osaka, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiyu","family":"Takeda","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Asanogawa General Hospital 11 , , ,","place":["Kanazawa, Ishikawa, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuhide","family":"Naruse","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center 5 , ,","place":["Kyoto, Japan"]},{"name":"Endocrine Center, Ijinkai Takeda General Hospital 12 , ,","place":["Kyoto, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akiyo","family":"Tanabe","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine 13 , ,","place":["Tokyo, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"ACPA-J Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","published-online":{"date-parts":[[2025,4,28]]},"reference":[{"key":"2026070710583236600_bib1","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1016\/S2213-8587(16)00086-3","article-title":"Complications of Cushing's syndrome: state of the art","volume":"4","author":"Pivonello","year":"2016","journal-title":"Lancet Diabetes 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