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Dorte Glintborg Department of Endocrinology, Odense University Hospital, Odense, Denmark
Institute of Clinical Research, University of Southern Denmark, Odense, Denmark

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Katrine Hass Rubin OPEN – Odense Patient data Explorative Network, Department of Clinical Research, University of Southern Denmark and Odense University Hospital, Odense, Denmark

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Mads Nybo Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark

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Bo Abrahamsen OPEN – Odense Patient data Explorative Network, Department of Clinical Research, University of Southern Denmark and Odense University Hospital, Odense, Denmark
Department of Medicine, Holbæk Hospital, Holbæk, Denmark

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Marianne Andersen Department of Endocrinology, Odense University Hospital, Odense, Denmark
Institute of Clinical Research, University of Southern Denmark, Odense, Denmark

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prospective development of type 2 diabetes, incident fractures, and cardiovascular disease ( 15 , 16 , 17 ) in the study cohort. The authors followed all of the STROBE guidelines in manuscript preparation. Assays in PCOS OUH Blood samples were

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Pinaki Dutta
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Bhuvanesh Mahendran Department of Endocrinology, Internal Medicine, Cardiology, Hematology, Histopathology, Gastroenterology, Neurosurgery, Pharmacology, Radiodiagnosis, 4th Floor, F Block, Post Graduate Institute of Medical Education and Research, Nehru Hospital, Chandigarh 160012, India

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K Shrinivas Reddy Department of Endocrinology, Internal Medicine, Cardiology, Hematology, Histopathology, Gastroenterology, Neurosurgery, Pharmacology, Radiodiagnosis, 4th Floor, F Block, Post Graduate Institute of Medical Education and Research, Nehru Hospital, Chandigarh 160012, India

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Jasmina Ahluwalia Department of Endocrinology, Internal Medicine, Cardiology, Hematology, Histopathology, Gastroenterology, Neurosurgery, Pharmacology, Radiodiagnosis, 4th Floor, F Block, Post Graduate Institute of Medical Education and Research, Nehru Hospital, Chandigarh 160012, India

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Kim Vaiphei Department of Endocrinology, Internal Medicine, Cardiology, Hematology, Histopathology, Gastroenterology, Neurosurgery, Pharmacology, Radiodiagnosis, 4th Floor, F Block, Post Graduate Institute of Medical Education and Research, Nehru Hospital, Chandigarh 160012, India

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Rakesh K Kochhar Department of Endocrinology, Internal Medicine, Cardiology, Hematology, Histopathology, Gastroenterology, Neurosurgery, Pharmacology, Radiodiagnosis, 4th Floor, F Block, Post Graduate Institute of Medical Education and Research, Nehru Hospital, Chandigarh 160012, India

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Prakamya Gupta Department of Endocrinology, Internal Medicine, Cardiology, Hematology, Histopathology, Gastroenterology, Neurosurgery, Pharmacology, Radiodiagnosis, 4th Floor, F Block, Post Graduate Institute of Medical Education and Research, Nehru Hospital, Chandigarh 160012, India

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Anand Srinivasan Department of Endocrinology, Internal Medicine, Cardiology, Hematology, Histopathology, Gastroenterology, Neurosurgery, Pharmacology, Radiodiagnosis, 4th Floor, F Block, Post Graduate Institute of Medical Education and Research, Nehru Hospital, Chandigarh 160012, India

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Mahesh Prakash Department of Endocrinology, Internal Medicine, Cardiology, Hematology, Histopathology, Gastroenterology, Neurosurgery, Pharmacology, Radiodiagnosis, 4th Floor, F Block, Post Graduate Institute of Medical Education and Research, Nehru Hospital, Chandigarh 160012, India

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Kanchan Kumar Mukherjee Department of Endocrinology, Internal Medicine, Cardiology, Hematology, Histopathology, Gastroenterology, Neurosurgery, Pharmacology, Radiodiagnosis, 4th Floor, F Block, Post Graduate Institute of Medical Education and Research, Nehru Hospital, Chandigarh 160012, India

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Viral N Shah
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Girish Parthan
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Anil Bhansali
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acromegaly patients with GHD previously. Despite higher GH and IGF1 levels in patients with acromegaly, they are at increased risk for low BMD. Paradoxically, fracture risk is increased in acromegaly patients even with increased BMD or BMC. So the improvement

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Paraskevi Kazakou Diabetes Centre, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

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Stavroula A Paschou Endocrine Unit, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

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Theodora Psaltopoulou Unit of Hematology and Oncology, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

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Maria Gavriatopoulou Unit of Hematology and Oncology, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

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Eleni Korompoki Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

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Katerina Stefanaki Endocrine Unit, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

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Fotini Kanouta Department of Endocrinology, Alexandra Hospital, Athens, Greece

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Georgia N Kassi Department of Endocrinology, Alexandra Hospital, Athens, Greece

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Meletios-Athanasios Dimopoulos Unit of Hematology and Oncology, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

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Asimina Mitrakou Diabetes Centre, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

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recovery in patients with vitamin D deficiency and hypocalcemia (124, 125, 126, 127, 128) Vertebral fractures (126) Vitamin D deficiency (123) Increased PTH (123) Home isolation and low sun exposure during lockdowns (123) ACE, angiotensin

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Barbara J Boucher Blizard Institute, Barts & The London school of Medicine & Dentistry, Queen Mary University of London, London, UK

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i6583. ( https://doi.org/10.1136/bmj.i6583 ) 62 Sanders KM , Stuart AL , Williamson EJ , Simpson JA , Kotowicz MA , Young D & Nicholson GC . Annual high-dose oral vitamin D and falls and fractures in older women: a randomized

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Florian Schederecker Institute of Epidemiology, Helmholtz Zentrum München – German Research Center for Environmental Health (GmbH), Neuherberg, Germany

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Alexander Cecil Molecular Endocrinology and Metabolism, Genome Analysis Center, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany

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Cornelia Prehn Molecular Endocrinology and Metabolism, Genome Analysis Center, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany

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Jana Nano Institute of Epidemiology, Helmholtz Zentrum München – German Research Center for Environmental Health (GmbH), Neuherberg, Germany

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Wolfgang Koenig Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany
Deutsches Herzzentrum München, Technische Universität München, DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany

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Jerzy Adamski Molecular Endocrinology and Metabolism, Genome Analysis Center, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
Lehrstuhl für Experimentelle Genetik, Technische Universität München, Freising-Weihenstephan, Germany
Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

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Tanja Zeller Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany
German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Germany

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Annette Peters Institute of Epidemiology, Helmholtz Zentrum München – German Research Center for Environmental Health (GmbH), Neuherberg, Germany
German Centre for Cardiovascular Research (DZHK), Partner Site Munich, Munich, Germany

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Barbara Thorand Institute of Epidemiology, Helmholtz Zentrum München – German Research Center for Environmental Health (GmbH), Neuherberg, Germany

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( 49 , 50 ). Unfortunately, BMI (which used in our analysis) is a relatively crude measure of body composition. Additionally, higher levels of SHBG are associated with increased frailty and fracture ( 11 , 51 ). Direct effect of SHBG – as

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Thabiso R P Mofokeng Department of Medicine, University of the Free State, Bloemfontein, South Africa

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Salem A Beshyah Department of Medicine, Dubai Medical College, Duabi, United Arab Emirates
Department of Endocrinology, Mediclinic Airport Road Hospital, Abu Dhabi, United Arab Emirates

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Fazleh Mahomed Department of Medicine, University of the Free State, Bloemfontein, South Africa

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Kwazi C Z Ndlovu Department of Medicine, University of the Free State, Bloemfontein, South Africa

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Ian L Ross Division of Endocrinology, Department of Medicine, University of Cape Town, Cape Town, South Africa

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prednisolone and dexamethasone has been associated with undesirable side-effects such as wakefulness, nocturia, ( 38 ), bone mass reduction ( 39 , 40 , 41 ), hip fractures ( 42 ), adverse metabolic health ( 43 , 44 ), and increased mortality ( 45

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Amarjit Saini Division of Clinical Physiology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden

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Linda Björkhem-Bergman Division of Clinical Geriatrics, Departments of Neurobiology, Care Sciences and Neurobiology, Karolinska Institutet, Stockholm, Sweden

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Johan Boström Division of Clinical Physiology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden

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Mats Lilja Division of Clinical Physiology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden

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Michael Melin Division of Clinical Physiology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden
Unit of Cardiology, Karolinska University Hospital, Stockholm, Sweden

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Karl Olsson Division of Clinical Physiology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden

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Lena Ekström Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden

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Peter Bergman Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden

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Mikael Altun Division of Clinical Physiology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden

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Eric Rullman Division of Clinical Physiology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden
Unit of Cardiology, Karolinska University Hospital, Stockholm, Sweden

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Thomas Gustafsson Division of Clinical Physiology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden

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/L) may also lead to muscle weakness, falls and fragility fractures in older people ( 1 ). These are highly significant public health issues in terms of morbidity, quality of life and costs to health services. vitamin D status has been proposed as an

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Panagiotis Anagnostis Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece

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Irene Lambrinoudaki 2nd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Medical School, Athens, Greece

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John C Stevenson National Heart and Lung Institute, Imperial College London, Royal Brompton and Harefield Hospitals, Guy’s and St Thomas’ NHS Foundation Trust, London, UK

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Dimitrios G Goulis Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece

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.58–2.82) and, respectively. However, MHT was associated with a reduced risk of colorectal cancer (HR 0.63, 95% CI 0.43–0.92) hip (HR 0.66, 95% CI 0.45–0.98) and total fractures (HR 0.76, 95% CI 0.69–0.85) ( 42 ). Notably, when the final results of WHI-1 were

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Fabienne A U Fox Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany

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Lennart Koch Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
University for Health Sciences, Medical Informatics and Technology (UMIT TIROL), Tirol, Austria

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Monique M B Breteler Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
Institute for Medical Biometry, Informatics and Epidemiology (IMBIE), Faculty of Medicine, University of Bonn, Bonn, Germany

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N Ahmad Aziz Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
Department of Neurology, Faculty of Medicine, University of Bonn, Bonn, Germany

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 = 2), technical/acquisition failure ( n  = 141) or ineligibility ( n  = 223). Participants were deemed ineligible if they had an amputation or a fracture of the tested arm within the last month. They were also excluded from participation if they were

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Barbara J Boucher The Blizard Institute, Queen Mary University of London, London, UK

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supplementation for incident fractures in those over 60 years. An accompanying comment states that the VITAL study showed ‘no important health benefits from supplementation in the general population of older adults’, even ‘when initially deficient’ ( 91 , 92

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