• Basel F Alqeeq, Mohammed Ayyad, Waseem J Almadhoun, Mohammad Aboabdo, Mosheer S Aldahdouh, Mohammed Al-Tawil, and Ahmed M Al-Ghazali.
• From the Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine.
• Ann Saudi Med. 2024 Jan 1; 44 (1): 556555-65.

Background And ObjectivesCushing's disease is a rare endocrine disorder. This review aimed to examine sex-specific differences in Cushing's disease.Design And SettingsA meta-analysis was performed on published articles discussing the gender impact of Cushing's disease.MethodsA systematic search was conducted to identify studies from Medline, Embase, CENTRAL and Scopus. Nine studies enrolling 1047 patients diagnosed with Cushing's disease were included in this meta-analysis.ResultsMale patients presented at a younger age (MD [mean difference]=-5.43; 95% CI [-5.78, -5.08]; P<.00001) than females. Male patients had a significantly higher prevalence of osteoporosis (RR [risk ratio]=1.75; 95% CI [1.36, 225]; P<.0001) and hypokalemia (RR=1.66; 95% CI [1.27, 2.16]; P=.0002). In addition, males had significantly higher rates of negative magnetic resonance imaging (RR=1.53; 95% CI [1.18, 2.0]; P=.002). No sex difference was observed in the prevalence of diabetes (RR=0.92; 95% CI [0.70, 1.22]); P=.57) and dyslipidemia (RR=1.33; 95% CI [0.88, 2.0]; P=.17).ConclusionCushing's disease has a worse clinical presentation in males and more diagnostic difficulties compared to females.

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