Adequately identifying patients at risk for osteoporotic fractures is a growing concern as our population ages. Our long term goal is to develop novel techniques, which in conjunction with bone mineral density (BMD), will better identify patients at risk for fracture and allow the clinical implementation of strategies to prevent fractures. The objective of the current study is to determine whether a novel minimally invasive method for in vivo measurement of cortical bone material properties can identify those who are at risk for fragility fractures of the hip and wrist. Our working hypothesis is that women with fragility fractures have altered cortical bone material properties that make them susceptible to these injuries. We further hypothesize that these altered bone matrix properties are not detectable with traditional testing methods, such as BMD. To test this hypothesis, we propose two aims:
Aim 1) Determine whether women with hip fractures have altered cortical bone tissue properties, as assessed in vivo by a new minimally invasive approach called reference point indentation, compared to women without fractures;
and Aim 2) Determine whether women with wrist fractures have altered cortical bone tissue properties, as assessed in vivo by reference point indentation compared to patients without fractures. We will compare cortical bone tissue properties, as assessed by in vivo reference point indentation at the mid-tibia, in three groups of postmenopausal women: 1) those with recent hip fractures (n=50);2) those with recent wrist fractures (n=50) and 3) age-similar controls without a history of fracture (n=50). In addition, we will assess hip and spine BMD by DXA as well as clinical characteristics, including vitamin D status, medication history, and lifestyle factors (e.g., smoking, alcohol, and physical activity). Successful completion of this project will provide novel information about possible clinical utilit of minimally invasive, in vivo bone indentation measurements as a tool to assess fracture risk.

Public Health Relevance

The proposed research is relevant to public health because it addresses the need for improved identification of those at greatest risk for fragility fracture. Ou study addresses this issue by testing whether women with hip and wrist fractures have altered cortical bone properties, as assessed by a novel, minimally invasive technique, called reference point indentation, that attempts to measure bone fragility by making a small indent in the bone surface that is about 3 to 4 times the width of a human hair.

Agency
National Institute of Health (NIH)
Type
Small Research Grants (R03)
Project #
1R03AG047861-01
Application #
8748096
Study Section
Special Emphasis Panel (ZAG1)
Program Officer
Salive, Marcel
Project Start
Project End
Budget Start
Budget End
Support Year
1
Fiscal Year
2014
Total Cost
Indirect Cost
Name
Beth Israel Deaconess Medical Center
Department
Type
DUNS #
City
Boston
State
MA
Country
United States
Zip Code
02215