Changes in clinical features of adrenal Cushing syndrome: a national registry study

Adrenal Cushing syndrome (CS) has been rarely studied in recent years in Japan. This study aimed to investigate clinical characteristics and their changes over time in patients with adrenal CS. We analyzed 101 patients with adrenal CS caused by adenoma, dividing them into two groups based on diagnos...

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Main Authors: Takuyuki Katabami, Shiko Asai, Ren Matsuba, Masakatsu Sone, Shoichiro Izawa, Takamasa Ichijo, Mika Tsuiki, Shintaro Okamura, Takanobu Yoshimoto, Michio Otsuki, Yoshiyu Takeda, Mitsuhide Naruse, Akiyo Tanabe, ACPA-J Study Group
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Language:English
Published: Bioscientifica 2025-05-01
Series:Endocrine Connections
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Online Access:https://ec.bioscientifica.com/view/journals/ec/14/5/EC-24-0684.xml
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author Takuyuki Katabami
Shiko Asai
Ren Matsuba
Masakatsu Sone
Shoichiro Izawa
Takamasa Ichijo
Mika Tsuiki
Shintaro Okamura
Takanobu Yoshimoto
Michio Otsuki
Yoshiyu Takeda
Mitsuhide Naruse
Akiyo Tanabe
ACPA-J Study Group
author_facet Takuyuki Katabami
Shiko Asai
Ren Matsuba
Masakatsu Sone
Shoichiro Izawa
Takamasa Ichijo
Mika Tsuiki
Shintaro Okamura
Takanobu Yoshimoto
Michio Otsuki
Yoshiyu Takeda
Mitsuhide Naruse
Akiyo Tanabe
ACPA-J Study Group
author_sort Takuyuki Katabami
collection DOAJ
description Adrenal Cushing syndrome (CS) has been rarely studied in recent years in Japan. This study aimed to investigate clinical characteristics and their changes over time in patients with adrenal CS. We analyzed 101 patients with adrenal CS caused by adenoma, dividing them into two groups based on diagnosis period: December 2011–November 2016 (later group, n = 50) and August 2005–November 2011 (earlier group, n = 51). Differences between the groups and comparisons with previous reports were assessed. Patients with subclinical CS were excluded. Adrenal incidentalomas were the most frequent reason for CS diagnosis (34%). Most patients exhibited few specific cushingoid features (2.5 ± 1.3), with moon faces and central obesity being the most common. Compared to earlier reports, specific cushingoid features were less frequent; nonetheless, no significant differences were observed between the earlier and later groups. All patients had midnight and post-dexamethasone suppression test serum cortisol levels exceeding 5 μg/dL. No significant differences were found between the groups regarding non-specific symptoms, endocrinological findings related to cortisol secretion, cardiometabolic commodities or infections, except for glucose intolerance and bone complications. The prevalence of metabolic disorders other than glucose intolerance and osteoporosis fluctuated over time. Sixteen patients developed cardiovascular diseases or severe infections. In conclusion, adrenal CS became less florid in the 2000s, showed no improvement in the following years, and remained associated with a high complication rate. Further research is needed to establish an early detection model for CS.
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publishDate 2025-05-01
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spelling doaj-art-ae1fdf1a7fdd4de3be7bbd1c8c72fc002025-08-20T03:52:57ZengBioscientificaEndocrine Connections2049-36142025-05-0114510.1530/EC-24-06841Changes in clinical features of adrenal Cushing syndrome: a national registry studyTakuyuki Katabami0Shiko Asai1Ren Matsuba2Masakatsu Sone3Shoichiro Izawa4Takamasa Ichijo5Mika Tsuiki6Shintaro Okamura7Takanobu Yoshimoto8Michio Otsuki9Yoshiyu Takeda10Mitsuhide Naruse11Akiyo Tanabe12ACPA-J Study GroupDepartment of Metabolism and Endocrinology, St. Marianna University Yokohama Seibu Hospital, Yokohama, Kanagawa, JapanDepartment of Metabolism and Endocrinology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, JapanDepartment of Metabolism and Endocrinology, St. Marianna University Yokohama Seibu Hospital, Yokohama, Kanagawa, JapanDepartment of Metabolism and Endocrinology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, JapanDivision of Endocrinology and Metabolism, Tottori University Faculty of Medicine, Yonago, Tottori, JapanDepartment of Diabetes and Endocrinology, Saiseikai Yokohama-shi Tobu Hospital, Yokohama, Kanagawa, JapanDepartment of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Kyoto, JapanDepartment of Endocrinology, Tenri Hospital, Nara, JapanDepartment of Diabetes and Endocrinology, Tokyo Metropolitan Hiroo Hospital, Tokyo, JapanDepartment of Endocrinology, Tokyo Women’s Medical University, Tokyo, JapanDepartment of Internal Medicine, Asanogawa General Hospital, Kanazawa, Ishikawa, JapanDepartment of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Kyoto, JapanDepartment of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine, Tokyo, JapanAdrenal Cushing syndrome (CS) has been rarely studied in recent years in Japan. This study aimed to investigate clinical characteristics and their changes over time in patients with adrenal CS. We analyzed 101 patients with adrenal CS caused by adenoma, dividing them into two groups based on diagnosis period: December 2011–November 2016 (later group, n = 50) and August 2005–November 2011 (earlier group, n = 51). Differences between the groups and comparisons with previous reports were assessed. Patients with subclinical CS were excluded. Adrenal incidentalomas were the most frequent reason for CS diagnosis (34%). Most patients exhibited few specific cushingoid features (2.5 ± 1.3), with moon faces and central obesity being the most common. Compared to earlier reports, specific cushingoid features were less frequent; nonetheless, no significant differences were observed between the earlier and later groups. All patients had midnight and post-dexamethasone suppression test serum cortisol levels exceeding 5 μg/dL. No significant differences were found between the groups regarding non-specific symptoms, endocrinological findings related to cortisol secretion, cardiometabolic commodities or infections, except for glucose intolerance and bone complications. The prevalence of metabolic disorders other than glucose intolerance and osteoporosis fluctuated over time. Sixteen patients developed cardiovascular diseases or severe infections. In conclusion, adrenal CS became less florid in the 2000s, showed no improvement in the following years, and remained associated with a high complication rate. Further research is needed to establish an early detection model for CS.https://ec.bioscientifica.com/view/journals/ec/14/5/EC-24-0684.xmladrenal cushing syndromeclinical featuresdiagnosisnational registryjapan
spellingShingle Takuyuki Katabami
Shiko Asai
Ren Matsuba
Masakatsu Sone
Shoichiro Izawa
Takamasa Ichijo
Mika Tsuiki
Shintaro Okamura
Takanobu Yoshimoto
Michio Otsuki
Yoshiyu Takeda
Mitsuhide Naruse
Akiyo Tanabe
ACPA-J Study Group
Changes in clinical features of adrenal Cushing syndrome: a national registry study
Endocrine Connections
adrenal cushing syndrome
clinical features
diagnosis
national registry
japan
title Changes in clinical features of adrenal Cushing syndrome: a national registry study
title_full Changes in clinical features of adrenal Cushing syndrome: a national registry study
title_fullStr Changes in clinical features of adrenal Cushing syndrome: a national registry study
title_full_unstemmed Changes in clinical features of adrenal Cushing syndrome: a national registry study
title_short Changes in clinical features of adrenal Cushing syndrome: a national registry study
title_sort changes in clinical features of adrenal cushing syndrome a national registry study
topic adrenal cushing syndrome
clinical features
diagnosis
national registry
japan
url https://ec.bioscientifica.com/view/journals/ec/14/5/EC-24-0684.xml
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