{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T18:40:14Z","timestamp":1787510414884,"version":"build-2736575974"},"reference-count":31,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008126","name":"Jeju National University Hospital","doi-asserted-by":"publisher","award":["2022-47"],"award-info":[{"award-number":["2022-47"]}],"id":[{"id":"10.13039\/501100008126","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Children and adolescents with intellectual disability (ID) experience substantial health disparities, yet their skeletal health has been overlooked. Early-onset osteoporosis and fracture remain underrecognized in this population. Hence, this study assessed the risk of osteoporosis with concomitant fracture in this population using nationwide cohort data. Materials and Methods: This population-based retrospective cohort study examined data from South Korea\u2019s National Health Insurance Service-National Health Information Database (2004\u20132021). In all, 75,790 individuals with ID and 922,921 control individuals aged 2\u201318 years were included. The primary outcome was osteoporosis with concomitant fracture occurring within 1 year before or after the osteoporosis diagnosis. The secondary outcome was osteoporosis with a pathological fracture. Results: The ID group had a significantly higher risk of developing osteoporosis with concomitant fracture than the control group (unadjusted hazard ratio [HR], 6.821; 95% confidence interval [CI], 5.065\u20139.187; p &lt; 0.001). This association remained significant after adjusting for demographic factors and medical comorbidities as a composite variable (HR, 4.385; 95% CI, 3.080\u20136.245; p &lt; 0.001) and after additional adjustment for cerebral palsy (HR, 3.331; 95% CI, 2.252\u20134.926; p &lt; 0.001). Subgroup analyses showed stronger associations in males (HR, 7.597), younger ages (7\u201311 years: HR, 9.501), and rural areas (HR, 8.882). Conclusions: Children and adolescents with ID have a high risk of osteoporosis with concomitant fracture. Early assessment and targeted strategies are needed to promote bone health in this population.<\/jats:p>","DOI":"10.3390\/medicina61101761","type":"journal-article","created":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T10:49:34Z","timestamp":1759142974000},"page":"1761","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Risk of Osteoporosis-Related Fracture in Children and Adolescents with Intellectual Disability"],"prefix":"10.3390","volume":"61","author":[{"given":"Jeong Rae","family":"Yoo","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Jeju National University Hospital, College of Medicine, Jeju National University, Aran 13-gil 15, Jeju 63241, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong Ho","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Jeju National University Hospital, College of Medicine, Jeju National University, Aran 13-gil 15, Jeju 63241, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"So Young","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Jeju National University Hospital, College of Medicine, Jeju National University, Aran 13-gil 15, Jeju 63241, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3296-3349","authenticated-orcid":false,"given":"Jun Hwan","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Jeju National University Hospital, College of Medicine, Jeju National University, Aran 13-gil 15, Jeju 63241, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun Jung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Jeju National University Hospital, College of Medicine, Jeju National University, Aran 13-gil 15, Jeju 63241, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1016\/j.ridd.2010.12.018","article-title":"Prevalence of intellectual disability: A meta-analysis of population-based studies","volume":"32","author":"Maulik","year":"2011","journal-title":"Res. 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