Previously in the literature, an association between those with vitiligo and an increased risk of developing osteoporosis has been speculated. A recent retrospective cohort study was conducted to investigate that link and the strength of the association; the study findings saw a high incidence of osteoporosis in patients with vitiligo compared with their counterparts without.

Osteoporosis is the condition of having weakened bones; this gradual reduction in bone density happens over a long period and can go undetected, especially in the early stages, until the person experiences a fall that breaks bones. The bones can become so brittle that minor stresses, such as bending over, can cause the bones to break. Certain risk factors for developing osteoporosis have been identified, such as being a woman and being menopausal. Of course, gender and other genetic components of a person are uncontrollable risk factors; however, identifying them is still useful in helping physicians recognise which patients are at potential risk of developing osteoporosis. Both vitiligo and osteoporosis patients have a shared characteristic, which is a low level of vitamin D; similar cytokine activity has been detected in vitiligo and autoimmune patients, and thus this potential association deserved further attention. Presently, GlobalData epidemiologists estimate that by the end of 2024, the total prevalent cases of all osteoporosis will be 49.8 million cases in men and women ages 30 years and over in the seven major pharmaceutical markets (7MM: US, France, Germany, Italy, Spain, UK, and Japan); that number is expected to increase to 52.5 million by the end of 2027.

A March 2024 cohort study, published in Archives of Dermatological Research, was conducted by Cohen and colleagues, which quantified the relationship between developing osteoporosis in those with vitiligo and those without. The rationale is based on osteoporosis and vitiligo patients both experiencing reduced serum levels of vitamin D. Participants were extracted from a large health services database in Israel for 2002–2018; 19,985 patients with a diagnosis of vitiligo formed the experiment group and 99,003 patients without vitiligo formed the control group. The controls were matched based on sex, age, body mass index (BMI), smoking status, and ethnicity. Comparisons between the two groups were made, and the findings were that certain characteristics increased the chance of patients with vitiligo developing osteoporosis. The main potential risk factors identified were age at the onset of vitiligo diagnosis, being female, and having hyperlipidemia. The odds of developing osteoporosis in patients with vitiligo were 2.13 times greater with every additional year in age for the age at the onset of vitiligo. Being female increased the odds of developing osteoporosis by 5.65 times compared to being male; having hyperlipidemia increased the odds of developing osteoporosis by 1.39 times compared to not having hyperlipidemia. A higher incidence of osteoporosis was seen in vitiligo patients, 2.6 per 1,000 person-years, compared to the control group, which had an incidence of 2.2 per 1,000 person-years.

Being female is already an existing established risk factor for osteoporosis; being female with vitiligo increases that risk further compared to females without vitiligo. The study also found associations between an increase in age at diagnosis with vitiligo and the condition diagnosed at an earlier age for vitiligo patients. These conclusive findings give useful insight into areas of vitiligo and osteoporosis association that are left to be explored in more depth and detail.

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