Fragility Fractures: The Neglected Role Of Cortical Porosity
Funder
National Health and Medical Research Council
Funding Amount
$865,474.00
Summary
We just discovered that bone lost with age occurs mostly from pores within the cortex (outer shell) of the bone; These pores become larger (porosity) making bones fragile. This process is poorly detected by bone density (currently used tool) so that most people with weak bones are missed. To address this issue, we have for the first time, develop a technology to accurately quantify porosity in living peoples. With teams around the world, we aim here to fill this gap in the diagnosis.
The Micro-structural Basis Of Bone Loss And Fragility After Menopause: A Longitudinal Co-twin Control Study
Funder
National Health and Medical Research Council
Funding Amount
$873,950.00
Summary
Every woman becomes postmenopausal. Not all lose bone or sustain fractures after menopause. We will identify women who lose bone and those who don't and so identify women at risk for fracture so that they can be targeted for treatment and identify those who do not need to be treated. This will be done by measuring bone structure and how strong the bone is using a new, safe, quick technology that can be used in clinical practice
Premature Mortality Post Fracture:A NSW Linked Data Study
Funder
National Health and Medical Research Council
Funding Amount
$391,012.00
Summary
Osteoporotic fractures are associated with increased morbidity and mortality. Anti-osteoporosis medications reduce re-fracture and possibly morality, yet osteoporosis is poorly treated. This study will link information from >260,000 people (45&Up study) with hospital admissions, medications and deaths to create the largest, detailed dataset of its kind. We will be able to determine cause of any fracture-associated mortality and the effect of medication to improve osteoporosis management.
Improving Outcomes In Osteoporosis And Bone Health
Funder
National Health and Medical Research Council
Funding Amount
$348,494.00
Summary
Osteoporotic fractures are a common and increasing problem as the population ages. They are associated with increased risk of re-fracture and early death yet most patients remain untreated. This proposal will identify which fracture patients are at highest risk of re-fracture and premature death (b) identify whether osteoporosis treatment decreases this risk and (c) increase osteoporosis awareness and treatment uptake by general practitioners with an integrated fracture risk prediction tool.
The Relationship Between Osteoporosis And Diabetes: Exploring The Bone-metabolism Interface
Funder
National Health and Medical Research Council
Funding Amount
$124,676.00
Summary
Osteoporosis and diabetes are two common conditions that affect many Australians. Diabetes patients have an increased risk of fractures, however the underlying mechanisms for this increased fracture risk is unknown. We hypothesise that there are changes in the bone remodelling as a result of increased insulin levels (as seen in type 2 diabetes) and will explore the factors that contribute to the increased fracture risk and examine how treatments can reduce fracture rates.
Osteoporosis is a common problem with increased premature mortality associated with hip and even more minor fractures. The cause of increased mortality is debated although osteoporosis treatment may decrease this risk. This study will be the first to examine survival of all subjects in NSW admitted for a fracture including cause for subsequent hospitalisation and treatment taken. This study will help define the cause of the mortality and the role of anti osteoporosis treatment on outcome.
Prediction Of Adverse Outcomes Following A Fragility Fracture
Funder
National Health and Medical Research Council
Funding Amount
$148,426.00
Summary
Individuals with an existing fracture are at increased risk of adverse outcomes such as re-fracture and premature mortality, but it is not clear why. We propose to evaluate risk factors, and prognostic models, for predicting the risk of adverse outcomes. We also propose to develop a quantitative risk-benefit framework for evaluating the clinical utility of such prognostic models and help ensure that therapies appropriately address real-life experience of osteoporotic patients.
The Effect Of Androgen Replacement Therapy On Bone And Muscle Health In Men With Chronic Kidney Disease
Funder
National Health and Medical Research Council
Funding Amount
$122,714.00
Summary
Low testosterone (T) levels are common in men with poor kidney function. Low T is known to cause reduced energy, decreased strength and low libido. Normal T is also needed for healthy bones and muscles. Men with kidney disease are already at risk of fractures, poor strength and quality of life. However, there are few studies that look at replacing T to men with kidney failure. We will investigate how low T affects bone and muscle and assess how giving T can benefit bone, muscle and function.
GENETIC PREDICTION OF FRACTURE IN A RISK-STRATIFIED POPULATION
Funder
National Health and Medical Research Council
Funding Amount
$363,000.00
Summary
Osteoporosis is a condition characterised by excessive bone loss and impaired bone quality, which ultimately results in fracture with minimal trauma. Osteoporosis affects 27% of women and 11% of men aged 60 years or above in the community, and costs Australia around $7 billion each year. Individuals with low bone mineral density (BMD) have a significantly higher risk of fracture than those with normal BMD. In the long-term (14-year) Dubbo Osteoporosis Epidemiology Study, more than half of indivi ....Osteoporosis is a condition characterised by excessive bone loss and impaired bone quality, which ultimately results in fracture with minimal trauma. Osteoporosis affects 27% of women and 11% of men aged 60 years or above in the community, and costs Australia around $7 billion each year. Individuals with low bone mineral density (BMD) have a significantly higher risk of fracture than those with normal BMD. In the long-term (14-year) Dubbo Osteoporosis Epidemiology Study, more than half of individuals with osteoporosis (e.g., low BMD) did not sustain a fracture, while approximately 60% of fracture cases had BMD above the high risk levels. Thus, BMD alone is not a good discriminant of fracture versus non-fracture cases. It is widely known that the liability to fracture is determined in part by genes. Previous studies, including from our group, have suggested a number of candidate genes that are associated with fracture risk. The fundamental issue that this study is concerned is that how and whether genetic markers could be used to facilitate case finding. It is proposed that common variations of certain genes are associated with fracture risk independent of BMD. That is, they can identify individuals at relatively high and low fracture risk after stratification for BMD. Hence, some markers may identify those individuals likely (and unlikely) to fracture even with low (osteoporotic) BMD. Similarly, some, possibly the same, markers may identify individuals at high risk of fracture despite relatively good (ie non-osteoporotic) BMD. It is further proposed that no single gene will achieve this outcome, but rather a small set of such gene polymorphisms will provide clinically useful risk information. This effect is entirely analogous to the use of clinical risk indicators (eg, age, weight, sex, family history, etc) to assess the risk of future fracture.Read moreRead less
The overall aim is to improve treatments and outcomes for people with osteoporosis. This will be achieved by better predicting those who are likely to fracture and subsequently those who do well post fracture from those who do poorly. Following an osteoporotic fracture there is an increased risk of re- fracture and of premature death. This research will define those risk factors for fracture, re-fracture and early death in a large group of men and women followed for over 20 years.