Impact of Different Classes of Osteoporosis Medications on Muscle Health in Older Adults - Osteosarcopenia is a geriatric musculoskeletal syndrome characterized by the coexistence of osteoporosis (a condition marked by low bone mass and deteriorated skeletal micro-architecture) and sarcopenia (a condition characterized by low skeletal muscle mass, strength, and/or functional capacity). This debilitating disorder places patients at the highest risk for bone fractures due to osteoporosis, and at high risk for falls due to sarcopenia. There is substantial evidence indicating an overlap in the pathophysiology of osteoporosis and sarcopenia. Under normal circumstances, numerous complex biochemical pathways mediate systemic communication between bone and muscle. A deterioration in these processes may affect both systems, leading to the development of osteosarcopenia. As of now, most pharmacotherapies for osteosarcopenia predominantly target osteoporosis, with limited information available on their impact on muscle health. This K23 award will support the career development of geriatrician and endocrinologist, Nami Safai Haeri, MD. He plans to use data from multiple clinical trials to explore the relationship between bone and muscle, providing new information about the impact of osteoporosis medications on muscle health in a cohort of older adults. This knowledge could significantly enhance the therapeutic approach to osteosarcopenia in a population that is at the highest risk for fractures, falls, and poor health outcomes. The specific goals of his research include: 1) Evaluate the impact of three different classes of osteoporosis medications on longitudinal changes in skeletal muscle health in older adults residing in long-term care facilities, 2) Explore associations between measures of bone quality and skeletal muscle health, and; 3) Examine the association of skeletal muscle mass measured by D3-creatine dilution and muscle ultrasound with markers of bone metabolism in participants undergoing osteoporosis treatment. Dr. Safai Haeri’s long-term goal is to improve health and quality of life in persons with osteosarcopenia and its complications. He aims to achieve this through the development and implementation of innovative diagnostic and management strategies. The knowledge and insights gained from his research, supplemented with an extensive training and mentoring plan, will aid him in becoming a leading clinical trialist and researcher in understanding the underlying mechanisms of osteosarcopenia. The findings from this K23 award will lay the groundwork for future studies exploring the effects of multi-component interventions on osteosarcopenia. These interventions may include the use of sclerostin or RANKL inhibitors and nutritional supplements like vitamin D. This work will further encourage collaborations with basic scientists to delve deeper into the mechanistic pathways underlying the crosstalk between muscle and bone.
