FRAX; Fracture prediction; Bone microarchitecture; Bone Texture; Osteoporosis; large nested project (Psy-CoLaus)
Shevroja Enisa, Lamy Olivier, Hans Didier (2018), Review on the Utility of Trabecular Bone Score, a Surrogate of Bone Micro-architecture, in the Chronic Kidney Disease Spectrum and in Kidney Transplant Recipients, in Frontiers in Endocrinology
, 9, 1-6.
Papadakis Georgios E, Hans Didier, Rodriguez Elena Gonzalez, Vollenweider Peter, Waeber Gerard, Marques-Vidal Pedro, Lamy Olivier (2018), Menopausal Hormone Therapy Is Associated With Reduced Total and Visceral Adiposity: The OsteoLaus Cohort, in The Journal of Clinical Endocrinology & Metabolism
, 103(5), 1948-1957.
shevrojaEnisa, Marques-VidalPedro, Aubry-RozierBerengere, HansGabriel, RivadeneiraFermando, LamyOlivier, HansDidier (2018), Cohort Profile: The OsteoLaus Study, design and cohort overview through the second follow-up visit, in International Journal Of Epidemiology
Gonzalez Rodriguez Elena, Lamy Olivier, Stoll Delphine, Metzger Marie, Preisig Martin, Kuehner Christine, Vollenweider Peter, Marques-Vidal Pedro, Waeber Gérard, Aubry-Rozier Bérengère, Hans Didier (2017), High Evening Cortisol Level Is Associated With Low TBS and Increased Prevalent Vertebral Fractures: OsteoLaus Study, in The Journal of Clinical Endocrinology & Metabolism
, 102(7), 2628-2636.
Shevroja Enisa, Lamy Olivier, Kohlmeier Lynn, Koromani Fjorda, Rivadeneira Fernando, Hans Didier (2017), Use of Trabecular Bone Score (TBS) as a Complementary Approach to Dual-energy X-ray Absorptiometry (DXA) for Fracture Risk Assessment in Clinical Practice, in Journal of Clinical Densitometry
, 20(3), 334-345.
Padlina I., Gonzalez-Rodriguez E., Hans D., Metzger M., Stoll D., Aubry-Rozier B., Lamy O. (2017), The lumbar spine age-related degenerative disease influences the BMD not the TBS: the Osteolaus cohort, in Osteoporosis International
, 28(3), 909-915.
Papadakis Georgios, Hans Didier, Gonzalez-Rodriguez Elena, Vollenweider Peter, Waeber Gérard, Marques-Vidal Pedro Manuel, Lamy Olivier (2016), The Benefit of Menopausal Hormone Therapy on Bone Density and Microarchitecture Persists After its Withdrawal, in The Journal of Clinical Endocrinology & Metabolism
, 101(12), 5004-5011.
Aubry-Rozier Bérengère, Chapurlat Roland, Duboeuf François, Iglesias Katia, Krieg Marc-Antoine, Lamy Olivier, Burnand Bernard, Hans Didier (2015), Reproducibility of Vertebral Fracture Assessment Readings From Dual-energy X-ray Absorptiometry in Both a Population-based and Clinical Cohort: Cohen's and Uniform Kappa, in Journal of Clinical Densitometry
, 18(2), 233-238.
Osteoporosis is a major public health issue and is expected to become even more important in the next decades with population aging. Clinical consequences of osteoporosis are fragility fractures (mainly vertebral), wrist, humerus and hip fractures. Hip fractures are the most serious, and are responsible for a significant increase in death and institutionalization. Vertebral fractures can be disabling and also increase mortality. Prior to a fragility fracture, the definition of osteoporosis is based on bone mineral density (BMD).Fracture risk assessment is crucial to identify subjects at high risk of fracture for whom treatment is most appropriate, and to avoid unnecessary treatment for subjects at low risk. Several effective pharmacological treatments have been shown to prevent osteoporotic fractures in clinical trials. However, many individuals that might benefit from treatment are not identified before a major fracture occurs.The rationale to improve fracture prediction is the modest performance of existing prediction scores. Indeed, inclusion of risk factors in the FRAX® model (FRAX: Fracture Risk Assessment tool) was predicated on their ability to predict fractures, independently of each other and independently of BMD, and to indirectly capture some aspects of bone quality. Studies using texture analysis of human cadaver vertebrae have suggested that trabecular bone score (TBS) is an interesting marker of changes in bone micro-architecture and captures clinically relevant information on skeletal changes independent of BMD. If TBS is able to provide a direct assessment of how some of these non-BMD risk factors affect fracture risk, then it could effectively replace one or more of these risk factors in future fracture risk algorithms. Alternatively, the TBS could be used as a covariate in the current FRAX model to improve fracture prediction.Thus, the objective of this project is to assess the importance of bone micro-architectural estimation in improving the current FRAX model by developing and validating a FRAX model including estimates of bone micro-architecture. The project will use already available data from Swiss and international cohorts representing over 45000 subjects (the largest cohort will be used to develop the model and the sum of the others cohorts will be used for validation).If successful, this work will lead to better fracture risk estimation and classification, which will improve targeting of interventions to prevent fragility fractures. Given the ageing of the population and the expected increase in osteoporotic fractures, the health and economic benefits of an improved risk estimator would be considerable. A clinical tool (such as online calculator or risk tables) will be developed for physicians to calculate fracture prediction, thus facilitating individual treatment. This project will enable a strong interdisciplinary collaboration between doctors, physicists, and statisticians directed towards a major public health problem.