Cushing’s syndrome in women: age-related differences in etiology and clinical picture
Authors' conclusion
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.
Study context
- Population
- Women with Cushing's syndrome (CS) treated at Rabin Medical Center (2000–2020) or Maccabi Healthcare Services, Israel (2005–2017); mean age 46.0 ± 15.1 years81 Cushing's disease (CD), 61 adrenal CS
- Participants
- 142 women
- Exposure
- Women with CS by age at diagnosis: ≤ 45 vs 46-64 vs ≥ 65 years
- Outcome
- Pituitary etiology
Methodological detailstwo centres, Approved by both Ethics Review Boards with waiver of consent
- Two centres
- Approved by both Ethics Review Boards with waiver of consent
Main finding
As reported in the abstract
P < 0.05
Observational data: associations, not effects.
Further findings
| Outcome | ≤ 45 | ≥ 65 | P value |
|---|---|---|---|
| Hypercortisolism diagnosed on screening after adrenal incidentaloma≤ 45 vs ≥ 65 | 15.0% | 53.8% | P < 0.001 |
| Weight gain≤ 45 vs ≥ 65 | 57.4% | 15.8% | P = 0.011 |
| Mean UFC≤ 45 vs ≥ 65 | mean 3.8 × ULN | mean 2.3 × ULN | P < 0.001 |
- Mean UFC: highest in women < 45, lowest in ≥ 65
Weight gain
- Weight gain in women < 45: 56.3% CD, 60.0% CS
- Weight gain in women ≥ 65: 50% CD, 0% CS
Original publication
Cushing’s syndrome in women: age-related differences in etiology and clinical picture. Pituitary. Published 14 December 2022. doi:10.
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