Could a simple supplement help delay osteoporosis?
Updated: Oct 6, 2020
Researchers in the Auckland Bone and Joint Research Group are undertaking a six-month trial of post-menopausal Auckland women to determine if an over-the-counter supplement can help improve bone health.
Rheumatologist, Professor Nicola Dalbeth, is leading the work and says many studies from around the world have shown people who have higher urate levels in their blood have stronger bones, and those who have very low urate levels have thinner bones.
What is osteoporosis?
The most common bone disease, osteoporosis causes bones to thin, and they are more easily fractured with the most frequent fractures in the hip, spine or wrist.
There are now approximately 80,000 fractures in older people in New Zealand each year, resulting in an economic cost of $1.15 billion.
Osteoporotic fractures are associated with increased death rates and substantial long-term loss of independence, in addition to the pain and disability acutely associated with a fracture event.
As a result, osteoporosis causes the loss of more disability-adjusted life years than any type of cancer, other than lung cancer.
“Therefore mildly elevated urate levels may be protective,” Nicola explains. “So we’re looking to see if an over-the-counter supplement, which increases urate levels, can have positive effects on bone health.”
Nicola’s research project is funded by the Auckland Medical Research Foundation and involves a clinical trial of 120 women, who have gone through menopause – as bone thinning occurs in females as part of aging.
“We are conducting a randomised controlled trial where half the women receive supplements to mildly increase the urate levels, and the other half receive placebo tablets. Then we monitor the women over six months to see if there are changes in their markers of bone health,” she says.
“We have a lot of safety measures built into the trial too, because if you’re studying whether a supplement might be helpful, then you need to make sure that it’s safe.
“There has been quite a lot of controversy in the past 5-10 years about which supplements might be useful for bone health,” she says. “Many people take calcium or vitamin D to promote bone health, but studies from my colleagues in the Auckland Bone and Joint Research Group have shown that calcium and vitamin D supplements are not very effective in keeping your bones strong, and calcium supplements increase the risk of heart attacks and strokes. We no longer recommend calcium supplements to protect bones.”
The AMRF project grant of $160,000 allows her team to run the study and complete the trial. Trial participants will be regularly tested and at the end of the trial the two groups compared to show the efficacy and safety of the treatment.
“It’s a really exciting project, and we wouldn’t be able to do the trial without that funding,” Nicola says. “And this trial is an important step as it provides a cost-effective way to test potential benefits and ensure safety before embarking on a larger, long-term study."
Nicola knows first-hand how life-changing bone and joint disease can be, as she splits her week between research as a Professor of Medicine at the University of Auckland and treating patients as a Specialist Rheumatologist at Auckland District Health Board.
“Each aspect of my job supports the other. Often, I’m faced with clinical problems that inform research questions. I also think working in research gives me a much better understanding of the conditions that I’m treating as well.” She credits the AMRF with being integral to her return to New Zealand after furthering her rheumatology research training in the United Kingdom.
“When I was coming back to New Zealand, and wanted to develop a research career, AMRF were the first to fund my work. That made a huge difference to me as a researcher at the start of my career.”
Sue Brewster, Executive Director of the AMRF, is eagerly awaiting the results. “Our AMRF donors,” she says, “have helped to provide the vital funding needed for Nicola’s work, and this has been integral to improvements in furthering the understanding and treatment of musculoskeletal diseases, and providing improved treatments for those people who live with the daily challenges of bone and joint-related diseases.
“We recognise the importance of keeping Nicola’s skills and knowledge in New Zealand. The AMRF has funded a variety of research projects that Nicola has been involved in over the past 15 years. In return, Nicola works tirelessly as an integral part of our dynamic research community and is also giving back through volunteering her time and expertise on a number of medical research committees and boards.”