Cushing's syndrome in women: age-related differences in etiology and clinical picture.
Corticotroph adenoma
Cushing’s syndrome
Pituitary
Women
Journal
Pituitary
ISSN: 1573-7403
Titre abrégé: Pituitary
Pays: United States
ID NLM: 9814578
Informations de publication
Date de publication:
Feb 2023
Feb 2023
Historique:
accepted:
20
11
2022
pubmed:
15
12
2022
medline:
11
2
2023
entrez:
14
12
2022
Statut:
ppublish
Résumé
To evaluate the clinical presentation, biochemical profile, and etiology of Cushing's syndrome (CS) in women stratified by age. Retrospective study of patients with CS, treated at Rabin Medical Center from 2000 to 2020, or Maccabi Healthcare Services in Israel from 2005 to 2017. Disease etiology, presentation and biochemical profile were compared according to age at diagnosis: ≤ 45, 46-64, or ≥ 65 years. Study was approved by the Ethics Review Boards of both facilities with waiver of consent. The cohort included 142 women (mean age, 46.0 ± 15.1 years):81 (57.0%) with Cushing's disease (CD), and 61 (43.0%) with adrenal CS. Pituitary etiology was more common among women < 45 (70.6%), compared with patients ≥ 65 years (31.6%) (P < 0.05). Among CS patients, hypercortisolism was diagnosed in the context of screening after an adrenal incidentaloma detection in 15.0% of patients < 45 and 53.8% of ≥ 65 years (P < 0.001). Weight gain was evident in 57.4% of women < 45 (56.3% CD, 60.0% CS), and 15.8% of women ≥ 65 years (50% CD, 0% CS) (P = 0.011). Mean UFC levels were highest for women < 45 (3.8 × ULN) and lowest for ≥ 65 years (2.3 × ULN) (P < 0.001). We have shown for the first time that women with CS ≥ 65 years of age more commonly have adrenal etiology. The initial presentation of CS also differs between age groups, where women < 45 years are likely to present with weight gain, while those ≥ 65 years are frequently diagnosed incidentally, when screening for hypercortisolism in the presence of an adrenal incidentaloma.
Identifiants
pubmed: 36515786
doi: 10.1007/s11102-022-01292-2
pii: 10.1007/s11102-022-01292-2
doi:
Substances chimiques
Hydrocortisone
WI4X0X7BPJ
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
144-151Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
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