Hip fracture risk in patients with Cushing’s syndrome: a population-based cohort study
Main finding · First diagnosis of hip fractures following the diagnosis of CSResult — go to the resultHazard ratio 1.57 95% CI 1.0–2.5Authors' conclusion
Endogenous Cushing's syndrome may be associated with an increased hip fracture risk, particularly in CD, driven mainly by older age at diagnosis and pre-existing osteoporosis, with no significant risk reduction after remission. These findings underscore the need for early fracture risk assessment and targeted osteoporosis management in patients with CS.
Study context
- Population
- Patients diagnosed with endogenous CS between 2000 and 2023 in the Clalit Health Services database in Israel, and matched controls; patients with a history of hip fractures prior to CS diagnosis excluded606 patients with CS and 2,988 matched controls, mean age at diagnosis 47.8 ± 17.1 years, 65.3% female
- Participants
- 606 vs 2,988
- Exposure
- Endogenous CS vs matched controls
- CSn = 606
- MATCHED CONTROLSn = 2,988reference
- Outcome
- First diagnosis of hip fractures following the diagnosis of CS
Methodological detailsmatched 1:5 to controls based on age, sex, socioeconomic status, and body mass index, competing risk analysis, Clalit Health Services database
- Matched 1:5 to controls based on age, sex, socioeconomic status, and body mass index
- Competing risk analysis
- Clalit Health Services database
Main finding
As reported in the abstract
Hazard ratio
1.57
95% CI 1.0–2.5
P = 0.05
By group
CSvs MATCHED CONTROLS
HR 1.57 (95% CI 1.0–2.5); P = 0.05
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value | |
|---|---|---|---|
| Hip fracture in patients with Cushing's disease (CD) (subgroup)CDvs MATCHED CONTROLS | HR 2.2 (95% CI 1.07–4.75) | P = 0.03 | |
| Hip fracture in patients with an adrenal source (subgroup)Adrenal sourcevs MATCHED CONTROLS | HR 1.3 (95% CI 0.6–2.8) | ||
| Hip fracture among patients with CS, without remissionvs in remissionNo significant difference between groups | HR for hip fracture 1.14 (95% CI 0.4–3.0) | ||
| 0.20.5125Ratio (log scale) |
Follow-up duration
- Hip fracture among patients with CS, without remission vs in remission: Without remission 4.3%
- Hip fracture among patients with CS, without remission vs in remission: In remission 3.6%
Factors independently associated with hip fracture (multivariate analysis)
- Older age at CS diagnosis and pre-existing osteoporosis independently associated with an increased risk of hip fracture
Original publication
Hip fracture risk in patients with Cushing’s syndrome: a population-based cohort study. Osteoporos Int. Published 22 October 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →