Monitoring Bone Loss And Response To Therapy Through Bone Material And Structural Composition
Funder
National Health and Medical Research Council
Funding Amount
$696,111.00
Summary
Millions of scripts are filled for treatment of osteoporosis. However, there is no way of knowing if these drugs are right for these individuals, if it improves bone strength or are actually doing harm. Bone density measurement is of limited value. We have developed a new analysis method that measures changes in bone structure that tell us if the treatment is or is not working so alternative treatment can be used. The aim of this study is to test this new method.
Menopause is one of the important risk factors for bone loss, structural decay and bone fragility. We aim to quantify the biochemical, microstructural and biomechanical basis of loss of bone strength during and after menopause. A cohort of 324 pairs of female-female twins aged 25 to 75 years old will be followed up for up to 9 years. Defining the structural basis of bone fragility provides a rational means to identifying women at risk for fracture.
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.
Effect Of Bisphosphonates On Bone Architecture And Glucose Metabolism In Men With Prostate Cancer Receiving Androgen Deprivation Therapy: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$566,215.00
Summary
Androgen deprivation therapy (ADT) is a type of hormonal treatment which is effective for prostate cancer treatment. However, ADT may cause bone fragility, weight gain, diabetes and heart disease. We will examine the effects of a bone strengthening treatment on bone structure and glucose metabolism in men receiving ADT. This trial should help in better define the risk benefit ratio of ADT, and therefore provide treating doctors with better guidance as to when and how to use this therapy.
In men, oestrogen may be important for strong bones and maintaining a healthy weight. Men with prostate cancer are given medical castration treatment to decrease testosterone, because testosterone is required for prostate cancer growth. Because oestrogen is derived from testosterone, they also have very low oestrogen levels. We want to conduct a trial in these men to find out whether giving back oestrogen will prevent bone loss and weight gain, among other health benefits.
Does Enhanced Vitamin D Activity In Bone Heal The Skeleton In Disorders Of FGF23 Excess?
Funder
National Health and Medical Research Council
Funding Amount
$855,925.00
Summary
X-linked hypophosphatemia (XLH) is a genetic disorder which results in phosphate wasting and rickets. This severe disorder has no effective treatment. We have compelling new evidence that the rickets in XLH is not primarily a disorder of low blood phosphate, but rather specific issue of low cellular levels and activity of vitamin D (1,25D) within bone. This proposal is designed to specifically demonstrate this new concept and outline a new paradigm for a new XLH treatment.
Bisphosphonate Therapy With Zoledronate Or Tenofovir Switching To Improve Low Bone Mineral Density In HIV-Infected Adults: A Strategic, Randomised Trial
Funder
National Health and Medical Research Council
Funding Amount
$716,300.00
Summary
Most HIV+ Australians receive tenofovir, a ‘preferred’ drug in all HIV treatment guidelines, and may do for decades, as HIV therapy is lifelong and because there are very few new HIV drugs. 40% of HIV+ adults have low bone density and HIV+ adults experience more fractures. Of all HIV drugs, tenofovir causes the most bone loss. This trial compares two approaches: a drug to improve bone density and switching tenofovir to another drug. This ‘treat versus switch’ approach is a world-first for HIV.
Targeting Nicotinamide Adenine Dinucleotide Biosynthesis To Improve Metabolism
Funder
National Health and Medical Research Council
Funding Amount
$844,596.00
Summary
Nicotinamide adenine dinucleotide (NAD) is a cellular metabolite that regulates many biological processes. NAD levels decline with age and also in obesity and interventions that increase NAD levels produce favourable metabolic effects. In this proposal we will utilise a range of novel experimental models to define the molecular pathways that mediate the beneficial effects of NAD.
Understanding Sphingolipid Mediators Of Insulin Resistance
Funder
National Health and Medical Research Council
Funding Amount
$643,447.00
Summary
Sphingolipids are a class of lipid metabolites that have a variety of functions within cells. It has been known for some time that an accumulation of excess lipid, including certain sphingolipids, can adversely impact insulin action and glucose metabolism in cells. In this project we will a combination of strategies to test the hypothesis that the sphingolipid profile can be manipulated to have favourable effects on metabolism.
Targeting Insulin Hypersecretion To Prevent Type 1 And Type 2 Diabetes
Funder
National Health and Medical Research Council
Funding Amount
$834,596.00
Summary
Diabetes develops when islet beta-cells fail to secrete insulin. While major differences exist in the mechanisms by which type 1 and type 2 diabetes develop, there is overlap in beta-cell susceptibility factors. We will investigate whether an islet 'overwork' response to excess nutrient loads underlies beta-cell susceptibility to failure in both types of diabetes. We will also develop novel pharmacological approaches to reduce islet 'overwork' to prevent and treat type 1 and 2 diabetes.