title: Gender differences in presentation and outcome of patients with Cushing's disease in Han Chinese.
abstract: The purpose of this study was to assess gender-related distinction in the performance of Cushing's disease (CD) regarding clinical features, radiological findings, neurological and endocrine status, surgical outcome, and quality of life in Han Chinese. A retrospective study was conducted on 87 patients treated by trans-sphenoidal surgery, between 2006 and 2011, at a single treatment center in Shandong Provincial Hospital, China. Features of CD were compared and quality of life was analyzed between genders. The female-to-male ratio was 2.78: 1. Results showed that men have a younger age of diagnosis (P<0.001), a larger adenoma diameter (P<0.001), and a higher invasion rate (P=0.032) and apoplexy rate (P=0.04) than women. To be specific, compared with women, men are more prone to suffering from osteoporosis, hypokalemia, sexual dysfunction, and hypertension (P<0.05), have significantly higher preoperative and postoperative (six months after surgery) cortisol levels (P<0.001, P=0.003) and a higher recurrence rate (30.43% vs. 7.81%; P=0.028). No significant differences were seen in the CushingQoL scores between genders. Therefore, male patients with CD need more careful and long-term follow-up than female patients.
authors.affiliation: Shandong Provincial Hospital Affiliated to Shandong University, Ji'nan 250021, P.R. China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Huan
authors.affiliation: Shandong Provincial Hospital Affiliated to Shandong University, Ji'nan 250021, P.R. China.
authors.forename: Yuanming
authors.initials: Y
authors.lastname: Qu
authors.affiliation: College of Life Science, Shandong Normal University, Ji'nan 250014, P.R. China.
authors.forename: Zongming
authors.initials: Z
authors.lastname: Ren
mesh_terms: D000236:Adenoma / Q000209:etiology / Q000523:psychology*; D000328:Adult; D000367:Age Factors; D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology / Q000523:psychology*; D002681:China; D005260:Female; D006801:Humans; D008297:Male; D008659:Metabolic Diseases / Q000209:etiology / Q000523:psychology*; D008875:Middle Aged; D047748:Pituitary ACTH Hypersecretion / Q000150:complications / Q000523:psychology* / Q000601:surgery*; D010911:Pituitary Neoplasms / Q000209:etiology / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D012727:Sex Characteristics; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cushing's disease; CushingQoL scores; gender differences; transsphenoidal surgery