Professor Tuan Nguyen Receives UNSW Sydney’s Highest Award
Garvan News 16/6/2017: Garvan warmly congratulates Professor Tuan Nguyen, who has been awarded a Doctor of Science degree from UNSW Sydney.
The Garvan Institute of Medical Research congratulates Professor Tuan Nguyen, who has received a Doctorate of Science (DSc) from the University of New South Wales.
Higher Doctorates are the highest academic award conferred by UNSW Sydney, and Prof Nguyen’s award is testament to his outstanding contributions to our understanding of osteoporosis.
Prof Nguyen, who leads the Genetic Epidemiology of Osteoporosis laboratory in Garvan’s Bone Biology Division, has for three decades been studying the genetic and lifestyle factors that contribute to bone fractures and osteoporosis. His discoveries have advanced clinical practice and influenced public health policy.
Prof Nguyen says, “My vision has always been ambitious – to reduce the numbers of bone fractures in the population as a whole, and to improve the quality and length of life of individuals with osteoporosis.”
As well as running his research laboratory, Prof Nguyen holds appointments as Professor at St Vincent’s Clinical School (UNSW Sydney), Adjunct Professor of Epidemiology and Biostatistics at University of Notre Dame Australia and Professor of Predictive Medicine at University of Technology Sydney.
A great many distinctions for a man who arrived in Australia in 1982 armed with little more than a few words of English! A young Tuan Nguyen fled Vietnam by boat in 1981, with his sister and brother, in the aftermath of the Vietnam War. After spending many months in a refugee camp in Thailand, he arrived in Sydney in 1982, where he quickly bought his first English dictionary. Prof Nguyen then began his working life as a kitchen hand in St. Vincent’s Hospital, Sydney, right next door to where his lab now sits at Garvan.
Determined to go to university, within a few years he had earned a degree in Epidemiology and Biostatistics from Macquarie University and Sydney University, and started to think about how he could apply analytical models to medicine. In 1990, at the invitation of Garvan’s Professor John Eisman AO, he joined Garvan to do just that. He began analysing data obtained from Garvan’s Dubbo Osteoporosis Epidemiology Study. The study was at that time in its infancy, but is now the world’s longest running study of osteoporosis in men and women. Prof Nguyen is now a Principal Investigator on the Dubbo Study, which has followed thousands of people from Dubbo in western NSW for over 25 years, monitoring bone fractures and collating medical information.
“I hoped to achieve my vision through innovative translational research: using data from hundreds or thousands of people, we planned to investigate how to identify those at risk of bone fractures earlier, enabling us to prevent fractures, improve clinical management of osteoporosis, and change lives,” explains Prof Nguyen.
The Dubbo Study, along with several global initiatives in which Prof Nguyen has been involved, have enabled many of his major contributions to the field of osteoporosis research, including:
- Advancing and advocating the idea of “individualised risk assessment” in bone loss and fracture;
- The development of the Garvan Fracture Risk Calculator, a predictive tool based on a groundbreaking algorithm that uses risk factors (age, sex, history of falls and fractures, and bone density) to provide individualised clinical assessments of bone fracture risk;
- Pioneering research into the genetics underlying osteoporosis and identifying gene profiles associated with bone density loss and fracture;
- Uncovering the links between bone fracture and reduced life expectancy;
- Utilising the interaction between muscle weakness, postural instability, and bone mineral density in the determination of an individual’s fracture risk.
It is a fitting time to celebrate the achievements of Prof Nguyen; he has been awarded his DSc on the eve of Refugee Week (18-24 June), an initiative of the Refugee Council of Australia. Refugee Week aims to “raise awareness about the issues affecting refugees and celebrate the positive contributions made by refugees to Australian society.”
Prof Nguyen’s wife, Gam, and many members of his family accompanied him to the graduation ceremony at UNSW Sydney.
Prof Nguyen’s peers celebrate his achievements with him. Prof Eisman, who is also an endocrinologist at St. Vincent’s Hospital, and founder of the Dubbo Study, says that Prof Nguyen is very deserving of this honour.
“It has been the greatest pleasure working with Tuan. I have long admired his amazingly insightful and incisive mind,” Prof Eisman says.
“From the very beginning, Tuan has had an amazingly prescient focus on individual outcomes – that is, precision medicine. I can honestly say that much of what we have achieved would not have been possible without his capacities and insights.
“He has made major contributions in the field of osteoporosis, epidemiology and individual risk assessment.”
Prof Nguyen says he is grateful to Prof Eisman, Professor Richard Heller and the late Professor Philip Sambrook, who mentored him as he worked towards his PhD in Medicine, which he received from UNSW Australia in 1997.
“I have been very fortunate with the people I’ve worked with, from those who shaped my career in my early days at Garvan – including Prof Eisman and my colleagues who quietly tolerated my stubbornness in doing things my own way – to the wonderful scientists, clinicians, and students I work with today, ” says Prof Nguyen.
While Prof Nguyen was not able to return to Vietnam for nearly 18 years, he has retained a close relationship and re-established a scientific involvement with his native country. He now visits Vietnam regularly and has set up a research laboratory in Ton Duc Thang University; he was one of the founders of the Vietnamese Osteoporosis Society; he has written 12 books and run workshops for more than 2000 scientists and doctors on topics such as research methodology, epidemiology and biostatistics and osteoporosis, and evidence based medicine in Vietnam.
On the tenth anniversary of the Vietnamese Osteoporosis Society, Prof Nguyen was awarded a prize for his contributions to osteoporosis research in Vietnam.
“It is delightful to see how highly respected Tuan is in Vietnam, as he works to improve research as well as healthcare in Vietnam and the region,” says Prof Eisman.
Prof Nguyen says, “I’m grateful that I’m able to pursue my passion in both countries.”
“Australia and the Australian people have been good to me, right from the beginning – I remember the friendly Qantas staff in 1982 who made the journey from Thailand to Australia a little bit easier, and the bookshop assistant who helped me buy my first Oxford English Dictionary, though I couldn’t pronounce the word ‘Oxford’ correctly!
“Lots of people growing up in Australia today don’t appreciate the freedom they have – freedom of expression, freedom to choose a life they want – and I urge them not to take for granted the opportunities they’ve been given.”
Prof Nguyen concludes, “This was my last graduation at UNSW, and it serves to remind me of how far I’ve come – but I’m also excited about the years ahead.
“I have many more great plans for osteoporosis research.”
DSc degrees are awarded in recognition of “a significant body of published scholarly work that establishes the graduate as a distinguished authority in an area of research, commanding worldwide recognition.”
They are relatively rare, with only 35 awarded since 1993, the earliest date of UNSW’s Graduate Research School records. Prof Nguyen’s is one of only seven awarded through the Faculty of Medicine, and the only one awarded at the June graduation ceremony.
Genetic Profiling Improved Accuracy of Fracture Prediction
From: Endocrinology Advisor
New research demonstrated that genetic profiling of bone mineral density (BMD) genetic variants enhanced the accuracy of fracture prediction beyond that of clinical risk factors alone.
“We created a personalized genetic profiling and found that people with a higher genetic risk score (GRS) had greater risk of fracture,” Tuan Nguyen, PhD, of the Garvan Institute of Medical Research and the University of Technology Sydney, Australia, told Endocrinology Advisor. “More importantly, we found that genetic profiling contributes to a more accurate fracture prediction over and above that of traditional clinical risk factors.”
The study was presented at the American Society for Bone and Mineral Research (ASBMR) 2016 Annual Meeting.
For the study, Dr Nguyen and colleagues aimed to determine the predictive value of genetic profiling in fracture prediction.
“We have known for some time that fracture is partly determined by genetic factors and that the strongest predictor of fracture risk — BMD — is a highly heritable trait,” Dr Nguyen said. “Over the past 10 years or so, we have identified more than 70 genetic variants that are associated with fracture or BMD. However, the magnitude of association between each of those variants and bone density is very modest, leading to the suggestion that genetics is not useful for predicting complex diseases. In this study, we asked whether a genetic signature based on the discovered variants could help better predict fracture risk for an individual.”
In all, researchers genotyped 71 BMD-associated genetic variants in 556 participants from the Dubbo Osteoporosis Epidemiology Study. They created a GRS, determined the rate of fragility fracture via X-ray reports from 1990 to 2009, and measured femoral neck BMD with dual energy X-ray absorptiometry.
According to results, participants with a fracture had a higher GRS than those without a fracture (P<.001), with the odds of fracture increasing by 47% for each score increase in GRS.
After adjustment for age, gender, prior fracture, fall, and femoral neck BMD, GRS remained significantly associated with fracture risk (odds ratio [OR], 1.44; 95% CI, 1.24-1.67).
Similarly, researchers reported that for hip fracture, a rise in GRS yielded an increased risk for fracture (OR, 1.66; 95% CI, 1.38-2).
In further analysis, the area under the curve (AUC) for the model with clinical risk factors was 0.71 (95% CI, 0.67-0.75). With the addition of GRS to the model, the AUC increased to 0.74 (95% CI, 0.70-0.78) and the integrated reclassification index (NRI) improved by 23% at cut-off value.
Likewise, the addition of GRS into the clinical risk factors-based model for hip fracture improved AUC from 0.80 (95% CI, 0.74-0.86) to 0.87 (95% CI, 0.82-0.91), and led to an NRI gain of 19% in correct reclassification of fracture vs non-fracture.
“A personalized genetic profiling of bone density-related genes can improve the accuracy of fracture risk assessment,” Dr Nguyen concluded.
He added that fracture is a serious skeletal disorder because it is associated with increased risk for death, more so in men than women, and that the assessment of fracture risk should be based on an individual’s genetic and clinical risk profile.
“I am hoping to incorporate genetic profiling into the existing Garvan Fracture Risk Calculator for personalized fracture risk assessment,” Dr Nguyen said.
Disclosures: Dr Nguyen reports no relevant financial disclosures.
Ho-Le TP, Center JR, Eisman JA, Nguyen HT, Nguyen TV. Abstract 1032. Prediction of fragility fracture risk by genetic profiling. Presented at: ASBMR 2016 Annual Meeting; September 16-19, 2016; Atlanta, Georgia.