Joshua Barzilay
Emory University School of Medicine, USA
Title: The relationship of hip fractures to markers of microvascular disease
Biography
Biography: Joshua Barzilay
Abstract
The microcirculation plays an important role in bone formation during the ante-natal period. It is not known whether microvascular disease in post-natal life plays a role in impaired bone health, such as osteoporosis. Here we review several epidemiological studies that we have conducted in recent years showing that hip fractures – one the most serious manifestations of osteoporosis - are associated with several markers of microvascular disease: (1) retinal vascular disease, (2) albuminuria, and (3) abnormal white matter volume on a brain MRI. We further show that the presence of albuminuria mediates the association of dementia (a brain disorder related in part to small vessel disease of the brain) with hip fracture risk. These findings, plus recent reports that specialized cells in the osseous microvasculature play an important role in post-natal bone formation, support the hypothesis that extra-osseous microvascular disease may signify the presence of osseous microvascular disease that leads to osteoporotic fractures. Finally, we review radiological studies that show diminished bone perfusion in association with osteoporosis.