GLP-1s may increase osteoporosis risk

• A big share of People are at present taking GLP-1 drugs, and with such an elevated curiosity, researchers have been analyzing different potential well being advantages of those medication outdoors of managing sort 2 diabetes and weight reduction.
• One examine offered at AAOS’ 2026 Annual Assembly discovered GLP-1s could assist enhance postoperative outcomes after sure orthopedic procedures.
• A second examine stories that GLP-1 use could also be related to an elevated danger for osteoporosis, gout, and osteomalacia in folks with sort 2 diabetes and weight problems.

Now, two new research not too long ago offered on the 2026 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS) provide insights on how GLP-1 drugs would possibly affect musculoskeletal well being, each positively and negatively.

Their outcomes are but to look in a peer-reviewed journal.

“GLP-1 drugs at the moment are broadly used for diabetes and weight administration, and their use is increasing quickly,” Haroun Haque, MS, a third-year medical pupil at SUNY Downstate Faculty of Drugs and lead investigator of this examine, instructed Medical Information As we speak.

“As a result of they have an effect on metabolism, irritation, cardiovascular well being, and metabolic perform total, it is very important perceive how they affect surgical restoration and musculoskeletal well being. As extra sufferers take these drugs, surgeons want proof to information protected and efficient perioperative care,” stated Haque.

“We centered on the ten most typical orthopedic procedures as a result of they characterize a big portion of musculoskeletal surgical care in the US,” he continued. “These surgical procedures continuously contain sufferers with weight problems and metabolic disease, who’re most probably to be prescribed GLP-1 drugs.”

On the examine’s conclusion, researchers discovered that use of GLP-1 and semaglutide was correlated with considerably decrease probabilities for postoperative emergency division visits, with out an elevated surgical danger.

“Emergency division visits after surgical procedure are an essential indicator of issues and healthcare utilization,” Haque defined. “The affiliation between GLP-1 use and decrease emergency division visits suggests these drugs could also be linked to improved short-term restoration. Importantly, we didn’t observe proof of elevated surgical danger, which is reassuring given issues about perioperative administration.”

Moreover, scientists found the usage of GLP-1s was additionally linked to considerably decrease surgical web site an infection charges amongst sufferers present process TKA and THA.

“Infections after whole knee and whole hip arthroplasty are critical and dear issues,” Haque stated. “Seeing decrease an infection charges in GLP-1 customers raises the chance that improved metabolic management and decreased irritation could positively affect surgical outcomes. Even small reductions in an infection danger might have significant medical impression.”

“GLP-1 remedy use amongst orthopedic sufferers is rising quickly and is projected to proceed rising,” he continued. “Our findings counsel these drugs could also be linked to improved short-term postoperative outcomes; nonetheless we can’t set up causality based mostly on these retrospective outcomes and additional potential investigations are wanted.”

Within the second study, researchers centered on analyzing how GLP-1 use would possibly impression the chance of growing osteoporosis, gout, or osteomalacia (bone softening) in folks with sort 2 diabetes and weight problems.

Scientists analyzed digital medical information for greater than 73,000 folks and located that after 5 years, GLP-1 use was linked to a considerably greater danger of growing osteoporosis, in comparison with these not taking the remedy.

Researchers additionally discovered the next incidence of gout amongst GLP-1 customers, and the best relative danger improve was seen for osteomalacia.

“We’re simply now reaching the precipice the place 5- and 10-year follow-up knowledge have gotten accessible for sufferers taking GLP-1 drugs,” sayid Muaaz Wajahath, a fourth-year medical pupil at Michigan State College Faculty of Human Drugs and first investigator of this examine in a press release.

“Any remedy that sees this fast adoption warrants shut examination, notably in orthopedics the place weight problems and surgical intervention usually overlap, and when the long-term results of GLP-1 RA publicity on bone and joint well being stay poorly understood,” Wajahath detailed.

“At any time when you’ve a affected person who’s liable to osteoporosis, gout, or osteomalacia, clinicians ought to think about bone well being surveillance and monitor for delayed-onset issues in at-risk populations,” he added.

“These modifications might be carried out instantly and might be a simple repair to probably forestall these unintended effects,” stated Wajahath.

MNT had the chance to talk with Laurie Glasser, MD, a bodily drugs and rehabilitation doctor at Hackensack Meridian Well being’s Jersey Shore College Medical Middle in New Jersey, as to why GLP-1 use could be linked to the next danger for osteoporosis, gout, and osteomalacia in folks with sort 2 diabetes and weight problems.

In keeping with Glasser, who was not concerned in these research:

“There have been some stories of decreased bone mineral density (BMD) related to weight reduction, however the discount in BMD seems just like that seen with different weight-loss interventions and doesn’t translate into an elevated fracture danger. As well as, meta-analyses counsel that GLP-1 RAs may very well enhance bone density within the lumbar backbone and hip in contrast with controls.”

“Any fast weight reduction, together with from calorie restriction or bariatric surgery, is prone to be related to some bone loss, so I don’t assume blaming GLP-1s is the reply,” she added. “ GLP-1s are extraordinarily useful medication for my sufferers and, when used responsibly, have contributed to many optimistic outcomes.”

MNT additionally spoke with Bert Mandelbaum, MD, sports activities drugs specialist, orthopedic surgeon and co-director of the Regenerative Orthobiologic Middle at Cedars-Sinai Orthopaedics in Los Angeles.

Regarding the examine taking a look at GLP-1 use and orthopedic process postoperative danger, Mandelbaum, who was likewise not concerned within the latest research, stated that these outcomes affirm that docs are seeing much more use of GLP-1 agonists, and within the orthopedic surgical group that they’re mainly enhancing outcomes total.

“Affected person reported end result scores appear to be higher, revision charges are decreased, at the least on this inhabitants examine,” he continued. “So, what can we conclude from that? It’s going to take us some time to essentially type out the specificity of every little thing, however at the least the preliminary research are displaying that there’s advantages to the GLP-1 agonist.”

“That there are […] direct benefits, particularly affecting orthopedic and musculoskeletal points, that have an effect on bone, cartilage, muscle, and fats, altering physique composition in a really direct approach,” Mandelbaum defined.

“And as a consequence, there’s much less BMI. And likewise there’s a direct impact on the cells, the chondrocyte. And so they discovered the pathway, that it really works by the AMPK pathway that has a direct optimistic impact on the mitochondria and oxidative processes which can be to the optimistic. So it retains the chondrocyte, which is the cell that preserves cartilage and minimizes the development of arthritis, and due to this fact makes its perform higher.”

– Bert Mandelbaum, MD