2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T6f0,We assessed whether circulating adipokines are associated with incident fractures in patients with rheumatoid arthritis (RA). Three adipokines (adiponectin, leptin, and fibroblast growth factor [FGF]-21) were measured using banked enrollment serum from participants in a longitudinal RA cohort. Adipokine levels were dichotomized as high/low using median values. Incident osteoporotic fracture was defined based on published algorithms using diagnostic codes and confirmed by chart review. Cox proportional hazard models evaluated adipokines and incident fracture risk adjusting for age, sex, race, smoking status, body mass index (BMI), prednisone use, disease activity, comorbidity score, calendar year, osteoporosis history, and previous fracture. A total of 2,527 participants were included (89% male, mean age 72 years). There were 228 incident fractures over 27,540 person-years of follow-up (8.3 fractures per 1,000 person-years). After adjustment, the risk of incident fracture was increased for high levels of leptin (hazard ratio [HR] = 1.47; 95% confidence interval [CI] 1.15-1.90; P = 0.003), FGF-21 [HR = 1.39; 95% CI 1.16-1.67; P < 0.001), and adiponectin (HR = 1.21; 95% CI 0.94-1.55), with the latter not achieving significance (P = 0.13). Participants who had elevated levels of all three adipokines experienced twice the risk of fracture compared with those in whom none was elevated (HR = 2.17; 95% CI 1.27-3.70; P = 0.005). Elevations in adipokines are associated with an increased risk of fracture in patients with RA, independent of other established risk factors including BMI, smoking, and prednisone use. This supports further investigation to understand whether this association is related to altered body composition or disrupted metabolic pathways.31:Ta95, Objective We assessed whether circulating adipokines are associated with incident fractures in patients with rheumatoid arthritis (RA). Methods Three adipokines (adiponectin, leptin, and fibroblast growth factor [FGF]‐21) were measured using banked enrollment serum from participants in a longitudinal RA cohort. Adipokine levels were dichotomized as high/low using median values. Incident osteoporotic fracture was defined based on published algorithms using diagnostic codes and confirmed by chart review. Cox proportional hazard models evaluated adipokines and incident fracture risk adjusting for age, sex, race, smoking status, body mass index (BMI), prednisone use, disease activity, comorbidity score, calendar year, osteoporosis history, and previous fracture. Results A total of 2,527 participants were included (89% male, mean age 72 years). There were 228 incident fractures over 27,540 person‐years of follow‐up (8.3 fractures per 1,000 person‐years). After adjustment, the risk of incident fracture was increased for high levels of leptin (hazard ratio [HR] = 1.47; 95% confidence interval [CI] 1.15–1.90; P = 0.003), FGF‐21 [HR = 1.39; 95% CI 1.16–1.67; P < 0.001), and adiponectin (HR = 1.21; 95% CI 0.94–1.55), with the latter not achieving significance ( P = 0.13). Participants who had elevated levels of all three adipokines experienced twice the risk of fracture compared with those in whom none was elevated (HR = 2.17; 95% CI 1.27–3.70; P = 0.005). Conclusion Elevations in adipokines are associated with an increased risk of fracture in patients with RA, independent of other established risk factors including BMI, smoking, and prednisone use. This supports further investigation to understand whether this association is related to altered body composition or disrupted metabolic pathways. 32:T765,Connections between long-term use of topical corticosteroids (TCSs) of varying potency and osteoporosis and major osteoporotic fracture (MOF) are unclear. Susceptibility to adverse bone effects of TCSs in different sex, age and ethnic groups is unknown too. To demonstrate the association between cumulative dose of TCSs of varying potency and osteoporosis and MOF in Taiwanese population, with stratified analysis of sex and age. We conducted a nationwide case-control study and obtained data from Taiwan National Health Insurance Research Database. Cumulative TCS doses in different exposure periods were calculated, and the potency of TCSs was converted to prednisolone equivalent. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for osteoporosis and MOF associated with TCS use. From 2017 to 2020, 129,682 osteoporosis cases and 34,999 MOF cases were selected and randomly matched with 518,728 and 139,996 controls by sex and age. We found clear dose-response relationships between long-term TCS exposure and osteoporosis and MOF. For example, compared to no TCS use, adjusted ORs of osteoporosis were 1.216 (95% CI 1.189-1.243), 1.260 (95% CI, 1.241-1.280) and 1.341 (95% CI, 1.314-1.369) for exposure to low, medium and high cumulative TCS doses, respectively, over 5 years. Adjusted ORs of MOF were 1.118 (95% CI 1.069-1.170), 1.191 (95% CI, 1.156-1.227) and 1.288 (95% CI, 1.238-1.340) for exposure to low, medium and high cumulative TCS doses, respectively, over 5 years. Stratified analysis showed women had higher ORs of osteoporosis and MOF compared to men. Younger people (<50 years) had highest OR of osteoporosis compared to other age groups. Higher cumulative TCS dose was associated with increased risk of osteoporosis and MOF. Long-term use of TCSs should be cautious, especially in susceptible populations such as women and young people.33:T903,AbstractBackgroundConnections between long‐term use of topical corticosteroids (TCSs) of varying potency and osteoporosis and major osteoporotic fracture (MOF) are unclear. Susceptibility to adverse bone effects of TCSs in different sex, age and ethnic groups is unknown too.ObjectivesTo demonstrate the association between cumulative dose of TCSs of varying potency and osteoporosis and MOF in Taiwanese population, with stratified analysis of sex and age.MethodsWe conducted a nationwide case–control study and obtained data from Taiwan National Health Insurance Research Database. Cumulative TCS doses in different exposure periods were calculated, and the potency of TCSs was converted to prednisolone equivalent. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for osteoporosis and MOF associated with TCS use.ResultsFrom 2017 to 2020, 129,682 osteoporosis cases and 34,999 MOF cases were selected and randomly matched with 518,728 and 139,996 controls by sex and age. We found clear dose–response relationships between long‐term TCS exposure and osteoporosis and MOF. For example, compared to no TCS use, adjusted ORs of osteoporosis were 1.216 (95% CI 1.189–1.243), 1.260 (95% CI, 1.241–1.280) and 1.341 (95% CI, 1.314–1.369) for exposure to low, medium and high cumulative TCS doses, respectively, over 5 years. Adjusted ORs of MOF were 1.118 (95% CI 1.069–1.170), 1.191 (95% CI, 1.156–1.227) and 1.288 (95% CI, 1.238–1.340) for exposure to low, medium and high cumulative TCS doses, respectively, over 5 years. Stratified analysis showed women had higher ORs of osteoporosis and MOF compared to men. Younger people (<50 years) had highest OR of osteoporosis compared to other age groups.ConclusionsHigher cumulative TCS dose was associated with increased risk of osteoporosis and MOF. Long‐term use of TCSs should be cautious, especially in susceptible populations such as women and young people.25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Osteoporotic Fracture: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Osteoporotic Fracture (condition). Clinician-written summaries and actionable practice insights. 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No significant fracture risk elevation was seen with SHOA. Path analysis suggested the association was independent of bone loss over time.","limitations":"- Relatively small ErHOA subgroup (n=141, 11.9%) limits statistical precision (wide CIs).\n- Path analysis exploring mechanisms was exploratory only, not confirmatory.\n- Follow-up was ~4.6 years; longer observation may be needed to capture full fracture burden.","practice_takeaway":"Postmenopausal women with erosive hand OA should prompt heightened fracture risk assessment, independent of standard bone density findings. Consider formal osteoporosis workup and fracture prevention strategies in this group, even when DXA results appear reassuring."}},{"doi":"10.1002/acr.25632","pmid":"40827014","title":"Adipokines and Associations With Incident Osteoporotic Fracture in Patients With Rheumatoid Arthritis","journal_title":"Arthritis Care & Research","journal_issn":"2151-464X","published_at":"2025-08-19T00:00:00.000Z","url":"https://doi.org/10.1002/acr.25632","source_score":14,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2025-12-02","doi":"10.1002/acr.25632","days":"7","issn":"2151-464X","rank":"5","field":"Clinical Medicine","score":"14","category":"Rheumatology","categories":["Rheumatology"],"_categories":["Rheumatology"]},"pubmed":{"doi":"10.1002/acr.25632","title":"Adipokines and Associations With Incident Osteoporotic Fracture in Patients With Rheumatoid Arthritis.","journal":"Arthritis care & research","methods":"","results":"A total of 2,527 participants were included (89% male, mean age 72 years). There were 228 incident fractures over 27,540 person-years of follow-up (8.3 fractures per 1,000 person-years). After adjustment, the risk of incident fracture was increased for high levels of leptin (hazard ratio [HR] = 1.47; 95% confidence interval [CI] 1.15-1.90; P = 0.003), FGF-21 [HR = 1.39; 95% CI 1.16-1.67; P < 0.001), and adiponectin (HR = 1.21; 95% CI 0.94-1.55), with the latter not achieving significance (P = 0.13). Participants who had elevated levels of all three adipokines experienced twice the risk of fracture compared with those in whom none was elevated (HR = 2.17; 95% CI 1.27-3.70; P = 0.005).","abstract":"$30","keywords":[],"pubmed_id":"40827014","conclusions":"Elevations in adipokines are associated with an increased risk of fracture in patients with RA, independent of other established risk factors including BMI, smoking, and prednisone use. This supports further investigation to understand whether this association is related to altered body composition or disrupted metabolic pathways.","publication_date":"2025-08-19T00:00:00"},"crossref":{"DOI":"10.1002/acr.25632","URL":"https://doi.org/10.1002/acr.25632","ISSN":["2151-464X","2151-4658"],"link":[{"URL":"https://acrjournals.onlinelibrary.wiley.com/doi/pdf/10.1002/acr.25632","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Adipokines and Associations With Incident Osteoporotic Fracture in Patients With Rheumatoid Arthritis"],"author":[{"given":"Joshua F.","family":"Baker","sequence":"first","affiliation":[{"name":"Corporal Michael J. 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dose–response information is not reported in the abstract.","value_numeric":null},{"paper_doi":"10.1002/acr.25632","tag_type":"warning","value":"Design classified as a cohort study based on the abstract; full methods were not reviewed.","value_numeric":null},{"paper_doi":"10.1002/acr.25632","tag_type":"warning","value":"Only total person‑years are provided; individual follow‑up duration is not specified.","value_numeric":null}],"summaries":{"what_studied":"A longitudinal cohort of 2,527 patients with rheumatoid arthritis (89% male; mean age 72) assessed whether baseline serum adiponectin, leptin, and FGF‑21 (dichotomized at the median) were associated with incident osteoporotic fractures confirmed by diagnostic codes plus chart review using adjusted Cox models.","key_result":"Over 27,540 person‑years, 228 fractures occurred (8.3 per 1,000 person‑years). High leptin was associated with higher fracture risk (HR 1.47; 95% CI 1.15‑1.90; P=0.003), as was high FGF‑21 (HR 1.39; 95% CI 1.16‑1.67; P<0.001); adiponectin was not statistically significant (HR 1.21; 95% CI 0.94‑1.55; P=0.13). Having all three adipokines elevated doubled risk versus none (HR 2.17; 95% CI 1.27‑3.70; P=0.005).","practice_takeaway":"In RA, elevated leptin and FGF‑21 correlated with higher fracture risk after adjustment for BMI, smoking, prednisone, and other factors; combined elevations doubled risk, while adiponectin was not significant. These associations are hypothesis‑generating and not practice‑changing pending further validation."}},{"doi":"10.1111/jdv.19697","pmid":"38115791","title":"Higher cumulative dose of topical corticosteroids is associated with osteoporosis and major osteoporotic fracture: A nationwide case–control study","journal_title":"Journal of the European Academy of Dermatology and Venereology","journal_issn":"0926-9959","published_at":"2023-12-20T00:00:00.000Z","url":"https://doi.org/10.1111/jdv.19697","source_score":174,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2023-12-24","doi":"10.1111/jdv.19697","days":"30","issn":"0926-9959","rank":"2","field":"Clinical Medicine","score":"174","category":"Dermatology","categories":["Dermatology"],"_categories":["Dermatology"]},"pubmed":{"doi":"10.1111/jdv.19697","title":"Higher cumulative dose of topical corticosteroids is associated with osteoporosis and major osteoporotic fracture: A nationwide case-control study.","journal":"Journal of the European Academy of Dermatology and Venereology : JEADV","methods":"","results":"From 2017 to 2020, 129,682 osteoporosis cases and 34,999 MOF cases were selected and randomly matched with 518,728 and 139,996 controls by sex and age. We found clear dose-response relationships between long-term TCS exposure and osteoporosis and MOF. For example, compared to no TCS use, adjusted ORs of osteoporosis were 1.216 (95% CI 1.189-1.243), 1.260 (95% CI, 1.241-1.280) and 1.341 (95% CI, 1.314-1.369) for exposure to low, medium and high cumulative TCS doses, respectively, over 5 years. Adjusted ORs of MOF were 1.118 (95% CI 1.069-1.170), 1.191 (95% CI, 1.156-1.227) and 1.288 (95% CI, 1.238-1.340) for exposure to low, medium and high cumulative TCS doses, respectively, over 5 years. Stratified analysis showed women had higher ORs of osteoporosis and MOF compared to men. 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Corticosteroid","value_numeric":null},{"paper_doi":"10.1111/jdv.19697","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/jdv.19697","tag_type":"study_design","value":"Case-Control Study","value_numeric":null},{"paper_doi":"10.1111/jdv.19697","tag_type":"warning","value":"Absolute risks and the dose cutoffs for low/medium/high exposure are not provided in the excerpt.","value_numeric":null},{"paper_doi":"10.1111/jdv.19697","tag_type":"warning","value":"Associations are reported as odds ratios from a case–control design and do not establish causation.","value_numeric":null},{"paper_doi":"10.1111/jdv.19697","tag_type":"warning","value":"Stratified sex- and age-specific effect sizes are described but not given numerically in the excerpt.","value_numeric":null}],"summaries":{"what_studied":"A nationwide case–control analysis of Taiwan’s National Health Insurance Research Database (2017–2020) examined whether cumulative topical corticosteroid (TCS) exposure, standardized to prednisolone-equivalent potency, is associated with osteoporosis and major osteoporotic fracture (MOF), with sex- and age-stratified analyses.","key_result":"Compared with no TCS use, over 5 years the adjusted odds ratios (ORs) for osteoporosis were 1.216 (95% CI 1.189–1.243), 1.260 (95% CI 1.241–1.280), and 1.341 (95% CI 1.314–1.369) for low, medium, and high cumulative TCS doses; for MOF, ORs were 1.118 (95% CI 1.069–1.170), 1.191 (95% CI 1.156–1.227), and 1.288 (95% CI 1.238–1.340). Women had higher ORs than men, and those <50 years had the highest OR for osteoporosis.","limitations":"Case–control design limits causal inference; the excerpt does not specify dose thresholds defining low/medium/high exposure or report absolute risks; findings are from a Taiwanese population, which may affect generalizability.","practice_takeaway":"Long-term, higher cumulative TCS exposure correlates with greater odds of osteoporosis and MOF; minimize cumulative TCS dose when possible and consider bone health vigilance, especially in women and adults under 50."}}],"initialOffset":3,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Osteoporotic Fracture"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Osteoporotic Fracture"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Osteoporotic Fracture"}}}]]

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