I am so grateful and thrilled to have been awarded the NHMRC Leadership Fellow  (previously known as Australia Fellow, Senior Principal Fellow). This important grant will help me realize the idea of precision risk assessment of fracture and gain a better insight into age-related bone loss.
The Minister for Health has announced the outcome of the NHMRC Investigator Grants this year . According to his press release, cancer research tops the list of grants with $87.1 million support, followed by infectious diseases (~$85 million), mental health ($54 million), and CVD research ($46.5 million). Osteoporosis research has received only $7.4 million, a modest share of the funding.
Globally, osteoporosis and fractures impose a substantial human and economic burden on the society and public health system. It is not widely known that a bone fracture, especially hip fracture, is associated with reduced survival (up to 15 years of life). Among those surviving a fracture, the majority will have some form of long-term physical disability and reduced quality of life. In Australia, the annual costs of osteoporosis are $3.8 billion. With the rapid ageing population being taken place globally, the burden of osteoporosis and fracture will become a serious threat to the ideal of healthy ageing.
I consider that bone loss is the key factor that will help gain better insights into the development of osteoporosis and fracture. My previous work has shown that excessive bone loss is associated with an increased risk of fracture and fracture-associated mortality, and that an osteogenomic profile could help identify those with rapid bone loss. More recently, my group has shown that bone loss was an important mediating factor that explains the relationship between antiresorptive therapies and reduced mortality risk among osteoporotic patients.
With this grant, I will be able to investigate the contribution genetic variants and non-genetic factors to age-related bone loss. I will use this knowledge to identify individuals at high risk of excessive bone loss for early prevention. My team and I will analyse the data of ~4000 men and women whose bone parameters have been serially measured over the past 30 years as part of the Dubbo Osteoporosis Epidemiology Study, to identify genetic variants that are associated with bone loss. We will then develop a predictive model that includes genetic profiling and clinical risk factors, for personalised assessment of bone loss and fracture risk, and to develop web-based software for the prediction of fracture, re-fracture, survival, and treatment benefit [3-4].
My vision is to translate epidemiological and genomic discoveries into clinical and public health applications for osteoporosis-prone individuals. I envisage this “Translational Osteoporosis”, as I would like to call it, employs innovative advances arising from epidemiology, genomic technologies and data science to develop diagnostics and prognostics for benefiting osteoporotic patients and the general population.
Once again, thank you NHMRC for continually supporting my work.