Cushing’s syndrome causes bone loss, yet the risk of hip fractures remains poorly defined. In this nationwide cohort, patients showed a modestly increased risk of hip fracture, particularly soon after diagnosis. These results underscore the importance of early osteoporosis screening and timely fracture prevention strategies. Glucocorticoid-induced osteoporosis is a common complication of Cushing’s syndrome (CS). While the increased risk for vertebral fractures is well-established, evidence regarding hip fracture risk is limited. This study investigates the association between endogenous CS and hip fracture risk and examines the effect of remission on this risk. A nationwide retrospective matched-cohort study was conducted using the Clalit Health Services database in Israel, including patients diagnosed with endogenous CS between 2000 and 2023. Patients with CS were matched 1:5 to controls based on age, sex, socioeconomic status, and body mass index. The primary outcome was the first diagnosis of hip fractures following the diagnosis of CS. Patients with a history of hip fractures prior to CS diagnosis were excluded. The study included 606 patients with CS and 2,988 matched controls, with a mean age at diagnosis of 47.8 ± 17.1 years; 65.3
Among older men, most fractures occur in late life and are fall-related. We followed 1469 late-life (average age 90 years) men for 3 years to characterize the circumstances of 160 incident fall-related fracture events. Most were due to minimal trauma and occurred indoors when the activity level was normal or less. Of fractures in older men, most are fall-related and occur in men 80 years and older. To better guide the development of fracture prevention approaches in late-life men, detailed information on fall-related fracture events was collected in a cohort of 1469 active surviving men (mean age 90 years) in the Osteoporotic Fractures in Men study from March 2021 until November 2024. Participants were contacted every 4 months to identify fractures confirmed by radiographic report. Fractures are classified as fall- or non-fall-related and characterized by the degree of trauma. Participants further queried about where, when and how fractures occurred. During a mean follow-up of 3 years, there were 169 confirmed clinical fracture events not due to malignancy or severe external trauma; of these, 160 (94.7
Adolescent idiopathic scoliosis (AIS) is a common type of scoliosis, which occurs in 10 to 18-year-old adolescents and is often accompanied by osteopenia, but the etiology of osteopenia is still unknown. Exploring the etiology may play an important role in fully understanding the pathogenesis of AIS and drawing new treatment ideas. Understanding the etiology of osteopenia in AIS. This article conducted a comprehensive search across PubMed, Web of Science (WOS), and CNKI for literature concerning osteopenia in adolescent idiopathic scoliosis. The primary search strategy employed “(adolescent idiopathic scoliosis) AND (osteopenia)”, supplemented by additional keywords encompassing “bone mineralization disorders”, “hormones”, “leptin”, “calcitonin”, “vitamin K”, “treatment”, etc. The review prioritized recent, high-quality literature. This review disclosed the research process of osteopenia in AIS and expounded its possible pathogenesis resulting in osteogenic and bone metabolic abnormalities. Meanwhile, this review summarized some other possible pathogenesis, like gut microbiota, nutritional factors resulting in osteopenia in AIS. Furtherly, the article revealed the relationship between osteopenia and AIS treatment outcome. Osteopenia in AIS patients is caused by multiple factors. During the treatment of AIS, it may be necessary to intervene in osteopenia.
We respond to methodological questions raised in a “Letter to the Editor” regarding our retrospective case series on romosozumab treatment in osteogenesis imperfecta (OI). We clarify that the retrospective study design, the rarity of the disease, the small number of cases, and the exploratory nature of the analyses limit the methodological approaches as already acknowledged in our original manuscript. Thus, the primary concern is an inherent limitation of an exploratory study in a rare disease. Nevertheless, these data are helpful, as they generate new hypotheses given the currently very limited clinical data available.
