This research was completed on 31 August 2008
Published on 16 November 2005
Every three minutes, someone in the UK has a fracture due to osteoporosis.  It’s long been thought that our risk of breaking a bone increases as our bones get thinner with age. Research that shifts the focus from the quantity, to the quality of bone could lead to better ways to diagnose, prevent and treat osteoporosis.
What's the problem and who does it affect?
Broken bones bring pain, deformity and loss of independence
Broken bones bring pain, deformity and loss of independence People with osteoporosis have fragile bones that break easily. As more of us live longer, the fractures that result from osteoporosis are reaching epidemic proportions – half of the women in the UK, and one in five men, will suffer the condition after the age of 50.  Yet there is no satisfactory treatment. Many people don't even realise they've got osteoporosis until they break a bone. Breaks are alarming, painful and can have devastating consequences – people who suffer a hip fracture are at increased risk of dying.  It's not just quantity, but also quality that counts The strength of someone's bones, and their risk of fracture, is normally assessed with a bone density scan, which uses x-rays. This measures the density of bone. But recent studies suggest that it's the quality, as well as the quantity of bone that matters. If we are to retain our independence in later life, it is crucial that we find out exactly how the quality of bone deteriorates and how this can be prevented. It's not just quantity, but also quality that counts The strength of someone's bones, and their risk of fracture, is normally assessed with a bone density scan, which uses x-rays. This measures the density of bone. But recent studies suggest that it's the quality, as well as the quantity of bone that matters. If we are to retain our independence in later life, it is crucial that we find out exactly how the quality of bone deteriorates and how this can be prevented.
What is the project trying to achieve?
Investigating weak spots in osteoporotic bones
This is the project team’s third grant from Action Medical Research. With their first, they developed a prize-winning way to assess the quality of bone. This pinpoints areas where the bone is particularly weak, by counting microscopic breaks, or disconnections, within the honeycomb structure of bone. Further work showed that these areas of weakness are concentrated into 'hot spots' at common fracture sites (the spine and hip). These hot spots seem to be in places where special fibres, called Sharpey's fibres, penetrate into the bone. Sharpey's fibres attach muscle to bone and hold teeth in their sockets. In the current project, researchers aim to test their hypothesis that Sharpey's fibres somehow influence the development of areas of weakness in bone. They will examine the top of thigh bones discarded during surgery, and backbones from cadavers, using a variety of techniques.
What are the researchers' credentials?
|Project Leader||Dr J E Aaron PhD|
|Location||School of Biomedical Sciences, University of Leeds and Dewsbury District General Hospital, Leeds|
|Grant awarded||16 August 2005|
|Start date||1 September 2005|
|End date||31 August 2008|
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Dr Jean Aaron is an internationally recognised expert in the structure and function of bone. Since establishing the Bone Structural Biology Laboratory in Leeds, she's written more than 100 papers about the skeleton in health and disease in leading medical journals. A strong partnership between the laboratory and doctors at Dewsbury District Hospital who specialise in diseases of bone greatly facilitates studies into how disease affects bone. Dr Aaron believes the project team’s three consecutive grants from Action Medical Research have brought a vital element of stability to their work. Without this funding, she believes talented key members of the team would have been lost, making it difficult to build on their exciting discoveries. In 2001, the International Bone & Mineral Society awarded the project team with the millennium prize for best paper in the journal BONE. The paper describes work funded by the team's first grant from Action Medical Research.
Who stands to benefit from this research and how?
An estimated seven million people in the UK have osteoporosis
The potential benefit of research into osteoporosis is huge, simply because the disease is so common and its effects so devastating. What’s more, osteoporosis costs the UK more than £1.7 billion each year.  The broken bones that result from osteoporosis rob people of their mobility and independence. They cause long term pain and deformity. Fractures of the vertebra, for example, cause the bent, aching backs known as dowager’s humps. And the pain and general trauma of a hip fracture to a frail elderly person is indescribable. Sadly, hip fractures even put people at increased risk of dying. It is essential that researchers continue to improve understanding of how bone is weakened with age if they are to develop better ways to diagnose, prevent and treat osteoporosis so people can lead fuller lives for longer.
1. Secondary prevention of osteoporotic fragility fractures in postmenopausal women – Appraisal Consultation Document. London: National Institute for Clinical Excellence, May 2004 [back to main article] 2. van Staa TP, Dennison EM, Leufkens HG, Cooper C. Epidemiology of fractures in England and Wales. Bone 2001; 29:517-22. [back to main article] 3. Cummings SR, Melton JL: Epidemiology and outcomes of osteoporotic fractures. The Lancet 2002; 359:1761-67. [back to main article] 4. Population estimates, Office for National Statistics. Census 2001, Office for National Statistics. Census 2001, General Register Office for Scotland. [back to main article] 5. All Party Parliamentary Osteoporosis Group (APPOG). Falling short: Delivering integrated falls and osteoporosis services in England. December 2004 [back to main article]