My clinical research group focuses on the intersection of bone metabolism, metabolic disorders, and osteoporosis care delivery. Ongoing research projects include (1) studying skeletal health after bariatric (weight loss) surgery, (2) examining the impact of diabetes on skeletal strength, and (3) evaluating health disparities in osteoporosis management.  Utilizing a wide range of clinical study designs and advanced imaging techniques, we are investigating the pathophysiology, clinical consequences, and management of skeletal health in these diverse settings.  

Within the bariatric surgery field, my group has focused on documenting the scope and mechanisms of surgical bone loss and fracture risk.  We have discovered large declines in bone density and skeletal strength indices after bariatric surgery, and are actively investigating mechanisms that mediate this skeletal response.  Leveraging epidemiologic databases, we have also documented increased fracture risk after bartiatric surgery on a population basis.  We are now performing clinical trials of osteoporosis agents for the prevention of bone loss after bariatric surgery.

Within the diabetes field, my group is evaluating factors that contribute to the greatly increased fracture risk observed among adults with type 1 and type 2 diabetes.  In collaboration with colleagues, we are utilizing in vivo quantitative computed tomography (QCT)-based techniques as well as ex vivo bone specimen analyses to study the determinants of skeletal fragility in patients with diabetes.  Ultimately, we hope to develop new preventative measures and treatments to improve bone health in patients with diabetes.

My research group is also leveraging epidemiologic datasets to examine racial and ethnic disparities in osteoporosis.  Studying diverse populations is the first step to reducing health disparities and may lead to identification of socioeconomic, cultural, environmental and/or biologic factors that influence individual differences in fracture risk and osteoporosis outcomes.  Our group is evaluating disparities in diagnosis, treatment and consequences of osteoporosis.  We are also studying how race and ethnicity impact bone density, fracture prediction, and treatment efficacy among diverse populations.