My research program focuses on clinical studies of steroid-induced osteoporosis and transplant-related osteoporosis. Since returning to the Mayo Clinic from the University of Chicago in 1997, I have worked to develop collaborative clinical research protocols in these and other areas.

Research projects underway in the area of steroid-induced osteoporosis include an industry-funded study to prevent bone loss in patients with primary biliary cirrhosis with once-weekly bisphosphonate, in collaboration with Dr. Keith Lindor and colleagues of the Division of Gastroenterology.

Several research projects are underway in the area of transplant-associated osteoporosis. One project nearing completion is a retrospective analysis of prevention of bone loss in cardiac transplantation patients treated with intravenous bisphosphonate. Another project just completed is an analysis of bone histomorphometric changes before and after liver transplantation, in collaboration with Dr. Eileen Hay of the Division of Hepatology and Liver Transplantation. Another study, just completed in collaboration with Dr. Joseph Melton of the Department of Health Sciences Research and Dr. Line Vautour of McGill University in Montreal, Canada, evaluated fracture risk in Olmsted County patients who underwent renal transplantation between 1965-1995. Another study, in collaboration with Dr. James McCarthy of the Division of Nephrology, is evaluating hyperparathyroidism after renal transplantation. A further study, in collaboration with Dr. Timothy Larson and the renal transplant group, will investigate whether various immunosuppressive agents cause differential post-transplantation bone loss after renal transplantation.

Another research project under development, in collaboration with Dr. Joseph Melton of the Department of Health Sciences Research and Drs. Robert Greipp and S. Vincent Rajkumar of the Division of Hematology, includes an assessment of markers of bone turnover in patients with monoclonal gammopathy of undetermined significance. A recent population-based study in Olmsted County showed that these patients fracture more frequently in the axial skeleton than normal age-matched controls, suggesting bone loss begins before the development of the related disorder, multiple myeloma. A future study, also in collaboration with Dr. Joseph Melton of the Department of Health Sciences Research, will assess fracture risk in Olmsted County patients with end-stage renal disease.