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.
Fractures, in particular femoral neck (FN) fractures, are a huge public health problem resulting in disabilities, mortality and financial cost to the community. The prevention of these fractures is based on estimation of bone strength. The decision whether someone needs treatment, or the effectiveness of a treatment can only be judged by estimating bone strength. The bottom line is that currently we cannot correctly estimate bone strength. Present methods such as bone mineral density (BMD) perfo ....Fractures, in particular femoral neck (FN) fractures, are a huge public health problem resulting in disabilities, mortality and financial cost to the community. The prevention of these fractures is based on estimation of bone strength. The decision whether someone needs treatment, or the effectiveness of a treatment can only be judged by estimating bone strength. The bottom line is that currently we cannot correctly estimate bone strength. Present methods such as bone mineral density (BMD) perform poorly. Most people who fracture are not detected by BMD because their BMD is either normal or high, and many people with low BMD never fracture. The main aim of this grant application is to develop new tools to allow doctors and scientists worldwide to better estimate FN strength. To develop new methods to replace BMD, scientists need to make use of the 3D aspects of the bone such as size, shape and internal architecture. Presently, these 3D aspects (structure) have not been adequately studied and scientists incorrectly approximate them. As a result new methods are not any better. A good quantification of structure is needed. Another reason for the failure to accurately estimate the strength of bones is that estimates are based on a single parameter whereas the bone, like any architectural structure (e.g. building), comprises many components acting together to maintain its strength. To determine the strength based on density alone is incorrect; the size, the shape and things inside the structure need to be considered as a whole. After quantifying correctly the structure and components of bone strength, we will determine how they can be used individually and together to better estimate the strength of the FN in men and women. Tools generated will be used to better determine people likely to fracture and needing treatment; to better tailor and monitor treatments. A better understanding of the causes and epidemiology of fractures will ensue.Read moreRead less
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.
Control Of Musculoskeletal Function And Body Composition By Androgens In Men
Funder
National Health and Medical Research Council
Funding Amount
$594,248.00
Summary
Male sex hormone or androgen deficiency (AD) is a common, but under-diagnosed condition. AD decreases general well being and contributes to muscle weakness, bone fragility and weight gain. By using cutting edge imaging and molecular technologies, we will help to explain the underlying mechanisms of how AD leads to these negative effects. This should ultimately lead to reduction of adverse outcomes of AD, which include fractures and cardiovascular events.
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.
Control Of Musculoskeletal Function And Glucose Metabolism By Androgens In Men
Funder
National Health and Medical Research Council
Funding Amount
$245,031.00
Summary
Male sex hormone or androgen deficiency (AD) is a common, but under-diagnosed condition. AD decreases general well being and contributes to muscle weakness, bone fragility and weight gain. By using cutting edge imaging and molecular technologies, we will help to explain the underlying mechanisms of how AD leads to these negative effects. This should ultimately lead to reduction of adverse outcomes of AD, which include fractures and cardiovascular events.
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.