Endocrinology · 2 h ago
Cushing’s syndrome linked to modestly higher hip fracture risk
A nationwide matched-cohort study in Israel compared hip fracture incidence in 606 people with endogenous Cushing’s syndrome and 2,988 controls. Fracture risk was modestly higher overall, with a stronger association in Cushing’s disease; remission status was not significantly associated with lower risk.
- Hip fractures occurred in 3.9% of patients and 2.5% of controls.
- Cushing’s disease showed a stronger fracture-risk association.
- Remission status was not significantly associated with lower risk.
Researchers conducted a retrospective matched-cohort study using the Clalit Health Services database in Israel. The study included people diagnosed with endogenous Cushing’s syndrome between 2000 and 2023, matched five-to-one with controls by age, sex, socioeconomic status and body mass index. The primary outcome was a first hip fracture after diagnosis; people with a prior hip fracture were excluded.
Over approximately 14 years of follow-up, hip fractures occurred in 3.9% of patients with Cushing’s syndrome and 2.5% of controls. Competing-risk analysis found a modest association (HR 1.57, 95% CI 1.0–2.5; p=0.05). The association was stronger for Cushing’s disease (HR 2.2, 95% CI 1.07–4.75), but was not statistically significant for adrenal-source disease. Fracture incidence did not differ significantly by remission status. Older age at diagnosis and pre-existing osteoporosis were independently associated with fracture risk.
The findings support attention to fracture risk and bone health in endogenous Cushing’s syndrome, particularly in older patients and those with osteoporosis. However, the study was observational, the overall estimate was borderline, and remission was not associated with a significant reduction in hip fracture risk; it does not establish the effect of any screening or prevention strategy.
In practice
In people with endogenous Cushing’s syndrome, this cohort found hip fractures in 3.9% versus 2.5% of matched controls, with a stronger association among those with Cushing’s disease. Older age at diagnosis and pre-existing osteoporosis were independently associated with fracture risk. These findings support attention to bone and fracture risk in this population, but do not establish that a particular screening or prevention strategy improves outcomes. The overall association was borderline, and remission was not linked to a statistically significant reduction in hip fractures.
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Osteoporosis International: Hip fracture risk in patients with Cushing’s syndrome: a population-based cohort study ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.