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Gender-Specific Differences in Clinical Profile and Biochemical Parameters in Patients with Cushing's Disease: A
Xiaoxia Liu1, Xiaoming Zhu1, Meifang Zeng1
1Division of Endocrinology and Metabolism, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China.
Insights
Males with Cushing's disease (CD) exhibit more severe clinical presentations and adverse outcomes. This study highlights significant gender differences in CD, emphasizing the need for focused clinical attention on male patients.
Area of Science:
- Endocrinology
- Internal Medicine
Background:
- Cushing's disease (CD) disproportionately affects females.
- Males with CD often present with more severe clinical manifestations and poorer outcomes.
Purpose of the Study:
- To investigate gender-based differences in the clinical profile and biochemical parameters of Cushing's disease.
- To identify specific risk factors and complications associated with gender in CD patients.
Main Methods:
- Retrospective analysis of 73 Cushing's disease patients diagnosed between 2012-2013.
- Comparison of clinical presentations and biochemical data between male and female patients.
- Multiple linear regression analysis to assess correlations between risk factors and clinical outcomes.
Main Results:
- Males showed significantly higher levels of ACTH, BMI, HbA1c, systolic blood pressure, and hemoglobin compared to females.
- Increased incidence of fatty liver and altered hepatic function were observed in males.
- Gender was a significant predictor for hypokalemia, HbA1c, and systolic blood pressure, with males exhibiting more severe indicators.
Conclusions:
- Male patients with Cushing's disease experience more severe clinical symptoms, biochemical abnormalities, and complications.
- Healthcare professionals should increase vigilance in the diagnosis and management of Cushing's disease in males.
Abstract:
Cushing's disease (CD) is remarkably prevalent among females; however, more severe clinical presentation and adverse outcomes have been found in males. The purpose of this study was to investigate the overall clinical profile and biochemical parameters in patients with CD to identify the gender differences. Here we describe our series of CD patients referred to our medical center during 2012-2013. Among 73 cases, females presented a marked preponderance compared to males. Males had significantly higher ACTH, BMI, HbA1c, systolic blood pressure, and hemoglobin than females. For the first time, the incidence of fatty liver and hepatic function was also shown to be elevated in males. Multiple linear regression analysis was performed to further investigate the correlation of risk factors with hypokalemia, HbA1c, and systolic blood pressure. Gender and serum cortisol were associated with hypokalemia. Age, gender, and serum cortisol were significantly associated with HbA1c. Additionally, only gender was significantly associated with systolic blood pressure. Regarding clinical presentation, purple striae seemed to occur more frequently in males than in females. Thus, more severe clinical presentation, biochemical parameters, and complications were found in males than in females. Clinical professionals should pay more attention to the diagnosis and management of males with CD.
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