945 - The Impact of Glucocorticoid Use on Slipped Capital Femoral Epiphysis Risk in Obese Adolescents: A Retrospective Cohort Analysis

Slipped Capital Femoral Epiphysis (SCFE) is a serious orthopaedic condition that disproportionately affects obese adolescents. While glucocorticoid use is known to impair growth plate integrity, the combined effect of obesity and glucocorticoid exposure on SCFE risk remains poorly defined. We aim to answer four questions in this study: Does glucocorticoid use increase the risk of developing SCFE in obese adolescents? How does the incidence of SCFE compare between obese adolescents exposed to glucocorticoids and those not exposed? Does glucocorticoid exposure affect the timing of SCFE onset? Is there a difference in the frequency of SCFE diagnoses between the two groups?

Design:

A retrospective cohort study was conducted using the TriNetX Global Collaborative Network. Obese patients aged 8–18 years were divided into two cohorts: those exposed to glucocorticoids (n = 158,070) and those not exposed (n = 158,070), matched using propensity scores. The primary outcome was the development of SCFE over a one-year follow-up period. Statistical analyses included risk estimates, odds ratios, Kaplan-Meier survival analysis, and t-tests.

Results:

Glucocorticoid use was associated with a higher SCFE risk (risk ratio = 3.179, 95% CI: 2.665–3.792; p < 0.001). SCFE incidence was higher in the exposed group (0.003) compared to the non-exposed group (0.001), with a risk difference of 0.002 (95% CI: 0.002–0.003; p < 0.001). Kaplan-Meier analysis showed earlier SCFE onset in the glucocorticoid group (log-rank p < 0.001). The frequency of SCFE diagnoses was significantly greater in the exposed group (mean = 7.268 vs. 4.025; t = 5.395; df = 675; p < 0.001).

Conclusions: Glucocorticoid exposure significantly increases the risk and accelerates the onset of SCFE in obese adolescents. These findings support more cautious prescribing of glucocorticoids in this population and highlight the need for early screening and risk mitigation strategies. Future research should explore dose-response relationships and alternative treatment approaches.