Exploring Imaging Biomarkers as Early Warning Markers for Glucocorticoid-Induced Osteoporosis: A Longitudinal Cohort Study in Patients with Pemphigus Vulgaris

This study is a longitudinal cohort study in patients with pemphigus vulgaris (PV), aiming to explore whether novel imaging biomarkers, such as bone marrow fat-related quantitative parameters (e.g., R2* value), can serve as early warning markers for glucocorticoid-induced osteoporosis (GIOP). The study prospectively recruited PV patients and healthy subjects, dividing them into a glucocorticoid (GC) treatment group, a disease control group, and a healthy control group. Over an 18-month follow-up period, dynamic monitoring was conducted using methods such as magnetic susceptibility MRI, DXA bone mineral density, and serological markers, while other clinical manifestations of the subjects were recorded. By comparatively analyzing the relationships among imaging parameters, serological indicators, and clinical outcomes, the study seeks to identify imaging biomarkers for the early prediction of GIOP, which is expected to provide key imaging evidence for the early identification and intervention.