Faculty mentor/PI email address
swaghra1@virtua.org
Is your research Teaching and Learning based?
1
Keywords
GLP-1, OSA, Fractures, Vitamin D, Falls, Osteoporosis, Hospital Stay
Date of Presentation
5-6-2026 12:00 AM
Poster Abstract
Title: “GLP-1 Receptor Agonists in Obstructive Sleep Apnea: Association with Fractures, Bone Health, and Clinical Outcomes in a Propensity-Matched Cohort”
Background: GLP-1 receptor agonists have demonstrated benefits beyond glycemic control, but their impact on musculoskeletal and clinical outcomes in obstructive sleep apnea (OSA) remains poorly defined. We evaluated the association between GLP-1 agonist use and fractures, osteoporosis, vitamin D deficiency, falls, hospitalizations, and mortality in OSA patients without baseline fractures, osteoporosis, vitamin D deficiency, or alcohol use disorder.
Methods: A retrospective cohort study was conducted using the TriNetX Global Collaborative Network. Adults (≥50 years) with OSA and BMI ≥18.5 kg/m² were identified and stratified by GLP-1 agonist use (semaglutide, liraglutide, tirzepatide, or dulaglutide) versus no GLP-1 use. Patients with prior fractures, osteoporosis, vitamin D deficiency, or alcohol-related disorders were excluded. Propensity score matching (1:1) yielded 116,212 patients per cohort. Outcomes over a 2-year follow-up included fractures, incident vitamin D deficiency, osteoporosis, falls, inpatient admissions, and all-cause mortality. Risk ratios (RR) and hazard ratios (HR) with 95% confidence intervals were estimated.
Results: GLP-1 use was associated with higher risks of fracture (3.2% vs. 2.5%; RR 1.31, HR 1.87) and incident vitamin D deficiency (6.1% vs. 3.9%; RR 1.56, HR 2.25), and modestly higher osteoporosis incidence (HR 1.41, p< 0.001). Conversely, GLP-1 users had significantly lower rates of falls (3.4% vs. 5.1%; RR 0.67), inpatient admissions (12.0% vs. 31.1%; RR 0.39), and all-cause mortality (1.5% vs. 6.5%; RR 0.23; all p< 0.001).
Conclusions: In OSA patients without baseline bone or nutritional comorbidities, GLP-1 agonist use was associated with markedly reduced falls, hospitalizations, and mortality, but paradoxically higher fracture and vitamin D deficiency rates, warranting further investigation into bone health monitoring in this population.
Disciplines
Medicine and Health Sciences | Musculoskeletal Diseases | Respiratory Tract Diseases
GLP-1 Receptor Agonists in Obstructive Sleep Apnea: Association with Fractures, Bone Health, and Clinical Outcomes in a Propensity-Matched Cohort
Title: “GLP-1 Receptor Agonists in Obstructive Sleep Apnea: Association with Fractures, Bone Health, and Clinical Outcomes in a Propensity-Matched Cohort”
Background: GLP-1 receptor agonists have demonstrated benefits beyond glycemic control, but their impact on musculoskeletal and clinical outcomes in obstructive sleep apnea (OSA) remains poorly defined. We evaluated the association between GLP-1 agonist use and fractures, osteoporosis, vitamin D deficiency, falls, hospitalizations, and mortality in OSA patients without baseline fractures, osteoporosis, vitamin D deficiency, or alcohol use disorder.
Methods: A retrospective cohort study was conducted using the TriNetX Global Collaborative Network. Adults (≥50 years) with OSA and BMI ≥18.5 kg/m² were identified and stratified by GLP-1 agonist use (semaglutide, liraglutide, tirzepatide, or dulaglutide) versus no GLP-1 use. Patients with prior fractures, osteoporosis, vitamin D deficiency, or alcohol-related disorders were excluded. Propensity score matching (1:1) yielded 116,212 patients per cohort. Outcomes over a 2-year follow-up included fractures, incident vitamin D deficiency, osteoporosis, falls, inpatient admissions, and all-cause mortality. Risk ratios (RR) and hazard ratios (HR) with 95% confidence intervals were estimated.
Results: GLP-1 use was associated with higher risks of fracture (3.2% vs. 2.5%; RR 1.31, HR 1.87) and incident vitamin D deficiency (6.1% vs. 3.9%; RR 1.56, HR 2.25), and modestly higher osteoporosis incidence (HR 1.41, p< 0.001). Conversely, GLP-1 users had significantly lower rates of falls (3.4% vs. 5.1%; RR 0.67), inpatient admissions (12.0% vs. 31.1%; RR 0.39), and all-cause mortality (1.5% vs. 6.5%; RR 0.23; all p< 0.001).
Conclusions: In OSA patients without baseline bone or nutritional comorbidities, GLP-1 agonist use was associated with markedly reduced falls, hospitalizations, and mortality, but paradoxically higher fracture and vitamin D deficiency rates, warranting further investigation into bone health monitoring in this population.