# Metabolomic & Radiographic Markers of Fracture Risk Among Older Adults with Diabetes

> **NIH NIH K23** · DUKE UNIVERSITY · 2021 · $87,037

## Abstract

ABSTRACT
Among its medical complications, type 2 diabetes mellitus in older adults is associated with a
two-fold increase in the risk of hip and other low-trauma bone fractures. Paradoxically, this
increased risk occurs despite a higher average bone mineral density. This increased fracture
risk is likely multifactorial, stemming from metabolic dysfunction that results in both increased
falls risk and decreased bone strength. However, fracture risk stratification currently is limited
largely to bone density testing and clinical risk tools that do not perform adequately for adults
with diabetes. Because bone is both a metabolic and structural tissue, metabolomics and
biomechanical analyses would be particularly useful for developing and assessing new
measures of fracture risk. The objective of this application is to develop and evaluate
radiographic and laboratory biomarkers of fracture risk among older adults with diabetes,
utilizing biomechanical and translational measures. The proposed research has the following
aims: 1) Determine the association between metabolomic profiles and incident clinical fracture
among older adults with diabetes; 2) Compare geometric and biomechanical measures at the
femoral neck and intertrochanteric region among older adults with diabetes, with and without hip
fracture. This application builds upon the prior published work and clinical expertise of the
Principle Investigator, Dr. Richard Lee, and provides him additional research skills to assist with
his career development goal of understanding the interaction of chronic medical conditions on
the bone health of older adults, focusing on diabetes. Dr. Lee is a dual-trained Geriatrician and
Endocrinologist with expertise in metabolic bone disease. The primary training goals of this
proposal include the following: 1) Develop laboratory and analytical skills in translational science
that will be used in the development and evaluation of clinical biomarkers, including –omics
technologies; 2) Acquire principles and skills in biomechanical engineering and materials
science to integrate with clinical and epidemiological analyses. By integrating biomechanical
engineering and metabolomics approaches with epidemiologic research to identify new markers
of fracture risk, this application addresses a significant source of morbidity and mortality among
an increasing proportion of older adults.

## Key facts

- **NIH application ID:** 10106544
- **Project number:** 5K23AG058797-04
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** Richard Hsang-Yang Lee
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $87,037
- **Award type:** 5
- **Project period:** 2018-04-15 → 2023-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10106544

## Citation

> US National Institutes of Health, RePORTER application 10106544, Metabolomic & Radiographic Markers of Fracture Risk Among Older Adults with Diabetes (5K23AG058797-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10106544. Licensed CC0.

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