2010

• OA/ANZBMS/AMGEN Research Fellowship
• RACP/OA scholarship
• ANZ/Wicking Trust
• Myer Foundation scholarship
• Macquarie Group Foundation Fellowship
• OA/NHMRC scholarship

 

Finding out how likely someone is to have a fracture from osteoporosis i.e. assessing their fracture risk, can be useful in deciding how to treat a patient who has osteoporosis.  If someone is told that they may be at high risk of having a fracture, they may also decide to make changes in their lifestyle to improve the strength of their bones.  We will examine these 2 different uses of fracture risk assessments in 2 studies.  In one study, we will interview general practitioners to find about how they might use tools to assess fracture risk in their patients.  This will include finding ways to make it easier for GPs to perform calculations and finding out whether GPs would use fracture risk information to change their patient’s treatment or to motivate patients to change their behaviour to reduce their risk.  In the second study we will measure bone density and lifestyle behaviours in women who were made aware of their fracture risk in a study over 10 years ago.

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Testosterone treatment in men with Type 2 Diabetes Mellitus

Men with type 2 diabetes mellitus frequently have low testosterone levels (main male sex hormone). Lowered testosterone levels have been associated with worse diabetic control, greater insulin resistance and increased weight. Low testosterone levels are also associated with osteoporosis in men without diabetes. This large, double blind, placebo controlled, randomized trial will investigate the effect of intramuscular testosterone injections on a range of factors in men with type 2 diabetes, including bone mineral density.

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'Osteo-cise' - Better Bones for Life

A community, evidence-based, exercise, falls prevention and education program titled 'Osteo-cise: Better Bones for Life'. A collaborative project involving 3 centres (University of Melbourne, Western Hospital / Deakin University / Geelong Hospital) and Osteoporosis Victoria.

 

 

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This project addresses the balance between the benefits of dietary calcium on bone and any potential adverse cardiovascular outcomes. It also investigates the influence of vitamin D deficiency on these outcomes.

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Common pathways influencing osteoporosis and atherosclerosis risk

Osteoporosis is a common skeletal disorder, affecting aging populations worldwide. There is strong evidence for a major genetic contribution to variation in bone density and bone metabolism from twin studies. Twin and family studies also show genes have a major effect on body fat, blood pressure and blood vessel function. There is evidence of inverse relationship between certain cardiovascular and bone risk factors. The proposed study will use the powerful twin model to examine the relationship between cardiovascular and bone risk factors. Twins provide advantage in medical research by reducing sample size that need to be studied due to matching for age, sex and many environmental and lifestyle factors.

Twin studies of osteoporosis have been running at the Royal North Shore Hospital since 1996, in conjunction within the Australian Twin Registry, recruiting large numbers of same sexed identical and non identical twins. Bone density has been measured and blood collected. Continued contact has been maintained with most twins by newsletters and repeat visits in many twin pairs. Given the relatively long period since baseline measurements were made, these twin studies offer the opportunity to unravel the interaction between bone, fat, cardiovascular risk factors and osteoporotic risk factors with a very large sample size and long duration of follow up (9 years).

The proposed research will investigate the following hypotheses using the powerful twin model:

• Bone mineral density (BMD) and bone strength measures are lower at clinically relevant sites in subjects who are hyperlipidemic and in subjects with impaired arterial stiffness or aortic calcification
• Loss of BMD is greater in patients with atherogenic risk factors than in subjects without them
• Atherogenic risk factors are associated with within-pair differences in biochemical markers of bone turnover and in circulating levels of relevant hormones and cytokines, demonstrable by cross-trait, cross-twin analysis in discordant twin pairs

The project is likely to lead to a better understanding of these diseases including the clinical importance of basic science in this area, better identification of those at high or low risk of the respective diseases and have therapeutic implications based upon risk factor modification.

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The role of male hormones in bone growth and development

This research project investigates the mechanisms of bone formation and the central role androgens play in regulating bone formation in males. Male osteoporosis is a significant and costly health problem. In my retrospective study supported by the National Arthritis and Musculoskeletal Conditions Improvement Grants, over 20% of patients admitted with a hip fracture were male, while 20% of General Practitioners who responded to the survey consider osteoporosis to be a female problem only. The impact of male osteoporosis to the community has only been recently recognised.

Androgens (male hormones) play an important role in the growth and maintenance of bone in males. Understanding the mechanisms of bone formation and the central role androgens play in regulating bone formation in males will allow determination of the less profound effects in females, which will provide avenues for the prevention and reversal of bone fragility in both men and women.

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The control of osteoclastic activity and its potential therapeutic treatment for bone diseases

Bone, a rigid yet dynamic organ, plays a crucial part in supporting the structure and mechanical functions of the body. Bone consists of two major cell types: osteoblasts (bone-forming cells) and osteoclasts (bone-eating cells). The imbalance in these two cell types results in bone diseases. For instance, an increase in the number of osteoblasts results in osteopetrosis. On the other hand, an increase in the number of osteoclasts results in osteoporosis (including postmenopausal osteoporosis), which is associated with brittle bones, leading to higher risks of fractures.

Currently, treatments for bone diseases, such as the Bisphosphonates and Estrogen Replacement Therapy relies heavily on chemical compounds and has been shown to lack specificity and cause adverse side effects. If, however, natural substances can be successfully identified for use in bone disease treatment, the side effects caused by chemical compounds can be markedly reduced.

The proposed study will investigate the following hypothesis using in vitro and in viva model.

• Natural compounds inhibits RANKL-induced osteoclasts differentiation and activation as well as osteoclastic bone resorption
• Natural compounds modulate RANKL-induced signalling pathways
• Collagen-induced arthritis mouse model treated with natural compounds could protect cartilage destruction and bone erosion in inflammatory conditions

The results obtained from this study will provide greater understanding into the molecular mechanisms of bone diseases resulting from increased osteoclastic activity. The newly identified natural compounds will provide a wider range of treatment options that are safe and effective for patients suffering from bone diseases.

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