Candidate: Margaret Gourlay, MD, MPH is an assistant professor of Family Medicine at the University of North Carolina. Career Development Plan: the candidate will participate in coursework and mentored research to learn essential skills in osteoporosis study design and implementation and to develop academic leadership. Immediate Objective: to acquire expertise in epidemiologic and densitometric concepts in osteoporosis screening research. Long-term Objective: to decrease fracture-related morbidity and mortality in the elderly by advancing the development of an evidence-based osteoporosis screening protocol for postmenopausal women under age 65 in primary care practices.
Specific Aims : 1) determine if two existing methods of fracture risk assessment are accurate in younger postmenopausal women, 2) determine if existing osteoporosis risk assessment tools are accurate in younger postmenopausal women, and 3) test the feasibility of a study of selective screening to identify osteoporosis in younger postmenopausal women. Research Methods:
in aims 1 and 2, secondary analyses of data from the two largest US osteoporosis cohort studies (NORA, SOF) will compare the ability of a fracture index vs. peripheral bone density to predict fracture in postmenopausal women aged 50 to 64, and will compare the ability of osteoporosis risk tools to identify peripheral osteoporosis in younger vs. older postmenopausal women.
In aim 3, a feasibility study that includes central and peripheral bone density measures will provide preliminary data for an R01 study of selective osteoporosis screening in younger postmenopausal women. Environment: patients will be recruited from 3 UNC primary care clinics and community family medicine clinics for the aim 3 feasibility study conducted in the NIH-funded General Clinical Research Center at UNC. Mentorship: mentorship will be provided by two highly successful NIA-funded researchers on aging (Drs. Sloane and Zimmerman), a national expert on screening methodology (Dr. Ransohoff), osteoporosis specialists (Drs. Rubin and Ontjes), and a biostatistical expert (Dr. Preisser). Investigators from NORA (Dr. Miller) and SOF (Dr. Ensrud) will supervise the analyses in aims 1 and 2. Relevance: osteoporosis is a common, preventable condition that leads to high fracture-related morbidity and mortality in postmenopausal women. This study will test osteoporosis screening strategies for postmenopausal women under 65 with the goal of preventing fracture.

Agency
National Institute of Health (NIH)
Institute
National Center for Research Resources (NCRR)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23RR024685-03
Application #
7641010
Study Section
National Institute on Aging Initial Review Group (NIA)
Program Officer
Wilde, David B
Project Start
2007-07-11
Project End
2012-06-30
Budget Start
2009-07-01
Budget End
2010-06-30
Support Year
3
Fiscal Year
2009
Total Cost
$132,425
Indirect Cost
Name
University of North Carolina Chapel Hill
Department
Family Medicine
Type
Schools of Medicine
DUNS #
608195277
City
Chapel Hill
State
NC
Country
United States
Zip Code
27599
Gourlay, Margaret L; Overman, Robert A; Fine, Jason P et al. (2016) Time to Osteoporosis and Major Fracture in Older Men: The MrOS Study. Am J Prev Med 50:727-736
Gourlay, Margaret Lee; Overman, Robert A; Fine, Jason P et al. (2015) Baseline age and time to major fracture in younger postmenopausal women. Menopause 22:589-97
Gourlay, Margaret L; Hammett-Stabler, Catherine A; Renner, Jordan B et al. (2014) Associations between Body Composition, Hormonal and Lifestyle Factors, Bone Turnover, and BMD. J Bone Metab 21:61-8
Gourlay, Margaret L; Preisser, John S; Lui, Li-Yung et al. (2012) BMD screening in older women: initial measurement and testing interval. J Bone Miner Res 27:743-6
Gourlay, Margaret L; Fine, Jason P; Preisser, John S et al. (2012) Bone-density testing interval and transition to osteoporosis in older women. N Engl J Med 366:225-33
Gourlay, Margaret L; Specker, Bonny L; Li, Chenxi et al. (2012) Follicle-stimulating hormone is independently associated with lean mass but not BMD in younger postmenopausal women. Bone 50:311-6
Schousboe, John T; Gourlay, Margaret L (2011) Comparative effectiveness and cost-effectiveness of strategies to screen for osteoporosis in postmenopausal women. Ann Intern Med 155:788-9
Gourlay, M L; Preisser, J S; Hammett-Stabler, C A et al. (2011) Follicle-stimulating hormone and bioavailable estradiol are less important than weight and race in determining bone density in younger postmenopausal women. Osteoporos Int 22:2699-708
Gourlay, Margaret L; Lewis, Carmen L; Preisser, John S et al. (2010) Perceptions of informed decision making about cancer screening in a diverse primary care population. Fam Med 42:421-7
Gourlay, Margaret (2009) Osteoporosis screening: mixed messages in primary care. Am Fam Physician 79:189-90

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