Metabolic syndrome in cushing’s syndrome patients: Does gender matter?

Introduction: Cushing’s syndrome (CS) results from chronic excess of glucocorticoids and is closely linked to various components of metabolic syndrome, increasing cardiovascular risk. The potential differences in complications between sexes remain a topic of debate. Methods: We conducted a comprehensive review of research focusing on sex-related differences in adiposity, adipokines, glucose and lipid metabolism, and cardiovascular disease in individuals with CS. Results: Obesity prevalence and body mass index (BMI) are generally comparable between sexes, but weight gain is more common in women. Hypercortisolism leads to visceral fat accumulation in both, with estrogen deficiency potentially worsening post-remission fat retention. Women exhibit higher leptin and lower adiponectin levels, while men are more prone to hypertriglyceridemia, lower HDL-C, and increased cardiovascular risks. Both sexes experience glucose intolerance and diabetes mellitus, with a non-significant trend of higher prevalence in women. Notably, sex differences may persist after biochemical remission, underscoring the importance of long-term monitoring and personalized risk assessments. Conclusion: Identifying sex-specific patterns in Cushing’s syndrome can be critical for enhancing personalized treatment approaches and guiding future research endeavors.