Prof Tuan Nguyen

Lab Head - Genetic Epidemiology of Osteoporosis

Principal Research Fellow

Dr. Tuan V. Nguyen is a Principal Research Fellow and Head of the Genetics and Epidemiology of Osteoporosis Lab (Bone Biology Division). He also holds joint appointments at the UNSW School of Public Health and Community Medicine as Professor of Epidemiology, and at the University of Technology, Sydney as Professor of Predictive Medicine. The primary focus of his research is on the discovery and translation of genetic and aetiologic factors that determine an individual's risk of fracture. He pursues both epidemiological and genetic research, often combining the two, to address issues that are transformational, shaping policy and practice leading to better treatment and control of osteoporosis. He is one of the highly cited scientists in the field of osteoporosis and medicine.

After arrviving in Australia 35 years ago as a refugee from Vietnam, he received his PhD in Medicine from the University of New South Wales for his work in the genetics of osteoporosis. He joined the Garvan Institute of Medical Research 25 years ago to work as a research officer and subsequently became a principal investigator of the Dubbo Osteoporosis and Epidemiology Study which is regarded as one of the world's longest running and most productive studies in osteoporosis. The Study has made significant contributions to a far better understanding of osteoporosis pathogenesis. In the mid-1990s, using data from the Dubbo study, he and his colleagues were among the first to show that the interaction between low bone mass and muscle weakness predicted fracture risk. Further work revealed that bone loss at clinically important sites (eg femoral neck) in the elderely neither decreased or stabilised as often stated in medical textbooks, but rather progressively increased with advancing age in men and women, and that bone loss contributed to the increased risk of fracture. His group was also among the first to estimate the residual lifetime risk of fracture for both men and women. 

In recent years, he and his colleagues have raised a new aspect of osteoporosis: mortality. All major fractures are associated with increased mortality, particularly during the first year after fracture in women and especially in men.  Furthermore, the loss of potential years of life is higher in the younger age-group clearly indicating that preventative strategies for fracture should not focus on older patients at the expense of younger women and men. At present, his group is working to identify aetiological factors that can explain the relationship between fracture and mortality. Addressing this relationship can lead a novel and early intervention that reduces the incidence of deaths among fracture patients.

He and his research group have been pioneering in the development of predictive models for assessing fracture risk and better disease management. One of his achievements is the translation of 20-year research into a prognostic tool called “Garvan Fracture Risk Calculator” for assessing fracture risk for an individual. This model was developed based on the concept of individualised assessment which he had advanced previously. The model has been implemented in mobile devices and a dedicated website (www.fractureriskcalculator.com) which has been used daily by doctors and patients from all over the world. He is working with UTS colleagues to develop a new instrument for assessing bone quality.

He is also a prominent figure in the field of genetics of osteoporosis through his work since mid-1990s. Using the candidate gene approach, his group has demonstrated the contributions of polymorphisms in the VDR, COLIA1, LRP5, and FTO genes to the prediction of fracture risk. Recently, the group has participated in international consortia that have discovered 56 bone mass loci. The group is now engaging in whole genome sequencing to identify rare genetic variants that can discriminate between those who will have a fracture from those who will not. The group's simulation work shows that genetic profiling could enhance the predictive accuracy of fracture prognosis and help identify high-risk individuals. Thus, Dr. Nguyen's vision is to create a "genomic signature" and to incorporate this signature into his Garvan Fracture Risk Calculator for individualising the risk of fracture and comorbidities for any person.

Dr. Nguyen has published more than 250 peer reviewed publications, review articles, book chapters, and commentaries or editorials, largely from his current research interests. His work has been published in highest impact journals in the field, notably the J Bone Miner Res (41 papers), J Clin Endocrinol Metab (25 papers), Osteoporosis International (31) and Bone (15). A number of key papers are published in more general journals, including New England Journal of Medicine, Lancet, JAMA, BMJ, Ann Int Med, Nature, Nature Genetics, Nature Rev Endocrinol. Some papers are considered pioneering in the field and has received applauded commentaries. His papers have been cited >19000 times; of which, 35 papers have been cited more than 100 times, and two papers with more than 1000 citations. His careerwise H index is 65, and his last five-year index is 42. 

Dr. Nguyen has contributed to the profession through his services in journal editorial boards and peer review. He has served on the Publication Committee of the American Society for Bone and Mineral Research (2008-2012). Currently, he is on the editorial board of journals such as the Journal of Bone and Mineral Research, Osteoporosis International, and Journal of Clinical Endocrinology and Metabolism, Academic Editor of PLoS ONE, and Associate Editor of BMC Musculoskel Disorders.  He is a regular reviewer for more than 20 medical and bone journals. He also contributed to grant review for many funding agencies around the world, including NHMRC, Wellcome Trust, NIH, WHO, Elan (Germany), New Zealand, Iceland, Israel, Hong Kong, Saudi Arabia.  He has been called on to offer opinions on applications for full professorship in the UCSD and UCLA. Dr. Nguyen regularly speaks or gives lectures in major osteoporosis conferences. He has also been invited to serve on organising committees of various international conferences. 

Dr. Nguyen has extensive research collaboration, both nationally and internationally. To date, he has published with more than 150 co-authors from 10 different countries in 21 institutions from the USA, Europe and Asia. He has been appointed as a Visiting Professor at the Khon Kaen University School of Medicine (Thailand), Hanoi Medical School (Vietnam), and Ton Duc Thang University (Vietnam). During the past 15 years, he has conducted many workshops in research methodology, scientific writing, epidemiology and biostatistics, osteoporosis, and evidence based medicine in Thailand and Vietnam. His highly popular workshops have attracted and improved research capacity for thousands of doctors, health care professionals, and scientists. He is credited for having contributed to raise the scientific publication profile of Vietnam in the international arena.  He has published 12 books from his workshops in Vietnam, and has received a number of national awards and honours for his work in his native country. He has recently helped establish a bone and muscle research laboratory in Vietnam. This lab is conducting large scale clinical and genetic research projects that complement his work in Australia. Dr. Nguyen is considered himself lucky to have worked with many great mentors and students from all over the world.  Through interaction with colleagues around the world, he often comes to the realisation that that he knows next to nothing.

Research Interests

Genetics and epidemiology of osteoporosis
Personalised medicine
Development of prognostic models for individualising fracture risk
Bayesian interpretation of clinical studies

Awards and Honours

2008-2013 - NHMRC Senior Research Fellowship
1998 - Garvan Best Thesis Award

Education

1997 - PhD (Medicine), University of New South Wales, Sydney - Australia

Selected Publications

Yang S, Center JR, Eisman JA, Nguyen TV. Association between fat mass, lean mass, and bone loss: the Dubbo osteoporosis epidemiology study. Osteoporos Int. 2015 Jan 9. 

Bliuc D, Nguyen ND, Alarkawi D, Nguyen TV, Eisman JA, Center JR.  Accelerated bone loss and increased post-fracture mortality in elderly women and men. Osteoporos Int. 2015 Jan 20.

Ahmed LA, Nguyen ND, Bjørnerem Å, Joakimsen RM, Jørgensen L, Størmer J, Bliuc D, Center JR, Eisman JA, Nguyen TV, Emaus N. External validation of the Garvan nomograms for predicting absolute fracture risk: the Tromsø study. PLoS One. 2014 Sep 25;9(9):e107695. 

Bliuc D, Alarkawi D, Nguyen TV, Eisman JA, Center JR. Risk of Subsequent Fractures and Mortality in Elderly Women and Men With Fragility Fractures With and Without Osteoporotic Bone Density: The Dubbo Osteoporosis Epidemiology Study. J Bone Miner Res. 2014 Oct 31. 

Chan MY, Center JR, Eisman JA, Nguyen TV. Bone mineral density and association of osteoarthritis with fracture risk. Osteoarthritis Cartilage. 2014 Sep;22(9):1251-8. 

Chan MY, Frost SA, Center JR, Eisman JA, Nguyen TV. Relationship between body mass index and fracture risk is mediated by bone mineral density. J Bone Miner Res. 2014 Nov;29(11):2327-35. 

Ho-Pham LT, Nguyen U, Nguyen TV. Association between lean mass, fat mass and bone mineral density: a meta-analysis. J Clin Endocrinol Metab 2014; 99:30-8. 

Yang S, Nguyen ND, Center JR, Eisman JA, Nguyen TV. Association between abdominal obesity and fracture risk: a prospective study. J Clin Endocrinol Metab. 2013;98(6):2478-83. 

Tran B, Nguyen ND, Center JR, Eisman JA, Nguyen TV. Association between fat-mass-and-obesity-associated (FTO) gene and hip fracture susceptibility. Clin Endocrinol (Oxf). 2013 Sep 21.

Frost SA, Nguyen ND, Center JR, Eisman JA, Nguyen TV. Excess mortality attributable to hip-fracture: A relative survival analysis. Bone 2013;56(1):23-29.

Chan MY, Nguyen ND, Center JR, Eisman JA, Nguyen TV. Quantitative ultrasound and fracture risk prediction in non-osteoporotic men and women as defined by WHO criteria. Osteoporos Int. 2013;24(3):1015-22.

Bliuc D, Nguyen ND, Nguyen TV, Eisman JA, Center JR. Compound risk of high mortality following osteoporotic fracture and re-fracture in elderly women and men. J Bone Miner Res 2013; Apr 24.

Styrkarsdottir U, Thorleifsson G, Sulem P, Gudbjartsson DF, Sigurdsson A, Jonasdottir A, Jonasdottir A, Oddsson A, Helgason A, Magnusson OT, Walters GB, Frigge ML, Helgadottir HT, Johannsdottir H, Bergsteinsdottir K, Ogmundsdottir MH, Center JR, Nguyen TV, Eisman JA, Christiansen C, Steingrimsson E, Jonasson JG, Tryggvadottir L, Eyjolfsson GI, Theodors A, Jonsson T, Ingvarsson T, Olafsson I, Rafnar T, Kong A, Sigurdsson G, Masson G, Thorsteinsdottir U, Stefansson K. Nonsense mutation in the LGR4 gene is associated with several human diseases and other traits. Nature. 2013;497(7450):517-20.

Nguyen HT, von Schoultz B, Nguyen TV, Dzung DN, Duc PT, Thuy VT, Hirschberg AL. Vitamin D deficiency in northern Vietnam: prevalence, risk factors and associations with bone mineral density. Bone. 2012;51(6):1029-34.

Chan MY, Nguyen ND, Center JR, Eisman JA, Nguyen TV. Absolute fracture-risk prediction by a combination of calcaneal quantitative ultrasound and bone mineral density. Calcif Tissue Int. 2012;90(2):128-36. 

Ho-Pham LT, Vu BQ, Lai TQ, Nguyen ND, Nguyen TV. Vegetarianism, bone loss, fracture and vitamin D: a longitudinal study in Asian vegans and non-vegans. Eur J Clin Nutr. 2012;66(1):75-82.

Tran BN, Nguyen ND, Nguyen VX, Center JR, Eisman JA, Nguyen TV. Genetic profiling and individualized prognosis of fracture. J Bone Miner Res. 2011;26(2):414-9. 

Frost SA, Nguyen ND, Black DA, Eisman JA, Nguyen TV. Risk factors for in-hospital post-hip fracture mortality. Bone. 2011;49(3):553-8.

Center JR, Bliuc D, Nguyen ND, Nguyen TV, Eisman JA. Osteoporosis medication and reduced mortality risk in elderly women and men. J Clin Endocrinol Metab. 2011;96(4):1006-14.

Langsetmo L, Nguyen TV, Nguyen ND, Kovacs CS, Prior JC, Center JR, Morin S, Josse RG, Adachi JD, Hanley DA, Eisman JA; Canadian Multicentre Osteoporosis Study Research Group. Independent external validation of nomograms for predicting risk of low-trauma fracture and hip fracture. CMAJ. 2011;183(2):E107-14

Ho-Pham LT, Nguyen ND, Nguyen TV. Effect of vegetarian diets on bone mineral density: a Bayesian meta-analysis. Am J Clin Nutr. 2009;90(4):943-50.

Frost SA, Nguyen ND, Center JR, Eisman JA, Nguyen TV. Timing of repeat BMD measurements: development of an absolute risk-based prognostic model. J Bone Miner Res. 2009;24(11):1800-7.

Bliuc D, Nguyen ND, Milch VE, Nguyen TV, Eisman JA, Center JR. Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA. 2009;301(5):513-21.

Styrkarsdottir U, Halldorsson BV, Gretarsdottir S, Gudbjartsson DF, Walters GB, Ingvarsson T, Jonsdottir T, Saemundsdottir J, Snorradóttir S, Center JR, Nguyen TV, Alexandersen P, Gulcher JR, Eisman JA, Christiansen C, Sigurdsson G, Kong A, Thorsteinsdottir U, Stefansson K. New sequence variants associated with bone mineral density. Nat Genet. 2009;41(1):15-7.

Reviews

Nguyen TV, Eisman JA. Genetic profiling and individualized assessment of fracture risk. Nat Rev Endocrinol 2013;9(3):153-61.

Nguyen TV, Center JR, Eisman JA. Individualized fracture risk assessment: progresses and challenges. Curr Opin Rheumatol 2013;25(4):532-41.

Nguyen TV, Eisman JA. Genetics and the individualized prediction of fracture. Curr Osteoporos Rep 2012;10(3):236-44.

Nguyen TV, Center JR, Eisman JA. Pharmacogenetics of osteoporosis and the prospect of individualized prognosis and individualized therapy. Curr Opin Endocrinol Diabetes Obes. 2008;15(6):481-8.

Prof Tuan Nguyen