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Training Grant-
Biology of Aging

Bjoern Buehring

Bjoern Buehring

MD, Charite-Universitaetsmedizin- Berlin
Assistant Professor, Department of Medicine- Geriatrics

Evaluation of Muscle Impairment (Sarcopenia), its Impact on Falls/Fractures and Potential Treatment Options

Osteoporosis is among the most common diseases affecting older adults in the United States with approximately 10 million individuals affected. Fifty percent of all women and 25% of all men over the age of 50 will experience a fragility fracture, the adverse event caused by osteoporosis, during their lifetimes. These fractures lead to significant disability, decreased quality of life and increased mortality. Given population demographics, the number of osteoporosis-related fractures is expected to increase for the foreseeable future. Recognition of this disease and provision of effective treatment can reduce fracture risk on both an individual and population level. Quality improvement in the areas of osteoporosis and falls reduction are foci in national initiatives including the Centers for Medicare and Medicaid Services' Physician Quality Reporting Initiative, the National Committee for Quality Assurance's Healthcare Effectiveness Data and Information Set. Specialists are needed to help improve the health care gap that currently exists in the field of osteoporosis. Moreover, the fracture reduction field is evolving to recognize the combined contribution of low bone mass and quality (osteoporosis) and low muscle mass and quality (sarcopenia) to fragility fracture risk.

My research interest focuses on how to best diagnose sarcopenia and osteoporosis, find risk factors that contribute to these disease and define meaningful outcomes related such falls and fractures but also quality of life and disability. Apart from developing a clinically relevant diagnosis and outcomes for sarcopenia and sarco-osteoporosis I am also interested in developing measures that will prevent and/or treat these disease. The goal of these therapies should be to improve mobility and quality of life and reduce falls, fractures and disability. One modality that has been shown to have multiple positive aspects on health is exercise. Apart from trying to find efficient ways of implementing traditional exercise regiments I am also interested in examining new ones such as whole body vibration. I am also part of studies examining pharmaceutical ways to treat sarcopenia and osteoporosis.

Before starting as a practicing physician and clinical scientist at the University of Wisconsin Madison and William S. Middleton Memorial Veterans Hospital I was fortunate to work at several other institutions including the Center for Muscle and Bone Research at the Charite in Berlin, Germany and the Rheumatology department at the Cleveland Clinic. My research projects included performing and analyzing muscle function tests in the first Berlin Bed Rest Study that was conducted in Berlin Germany. During my rheumatology fellowship at the Cleveland Clinic, I examined muscle, bone and fat tissue changes in persons with HIV as well as the role of muscle in individuals with osteoarthritis of the knee. For several years I have worked with Dr. Binkley at the UW Osteoporosis Clinical Center and Research Program. I was involved in studies on bone loss in bone marrow transplant survivors, vertebral fracture identification techniques and started examining jump mechanography as a method to assess musculoskeletal function in older adults, a project that we continued during my training in rheumatology at the Cleveland Clinic and now intensified again when I returned to Madison. Additionally, I participated in quality improvement projects to improve post hip fracture care at the VA in Madison and identifying patient groups with particularly large osteoporosis care gaps at the Cleveland Clinic. During these projects I developed a significant interest in health outcomes research.

In summary, I am interested in translational research at the more basic levels such as developing new methods to better assess muscle function to studies that examine exercise and pharmaceutical interventions to treat sarcopenia and osteoporosis to health outcomes research that involves improving post-fracture osteoporosis care.

Representative Publications
Carey, J. J., Lewiecki, E. M., Blank, R. D., Shuhart, C. R., & Buehring, B. (2017). Treatment of low bone density or osteoporosis to prevent fractures in men and women. Annals of Internal Medicine, 167(12), 901.
View publication via DOI: DOI:10.7326/l17-0487

Krueger, D., Siglinsky, E., Buehring, B., & Binkley, N. (2017). Total body less head measurement is most appropriate for lean mass assessment in adults. Journal of Clinical Densitometry, 20(1), 128-129.
View publication via DOI: DOI:10.1016/j.jocd.2016.08.068

Taani, M. H., Kovach, C. R., & Buehring, B. (2017). Muscle mechanography: A novel method to measure muscle function in older adults. Research in Gerontological Nursing, 10(1), 17-24.
View publication via DOI: DOI:10.3928/19404921-20161209-03

Yamada, Y., Buehring, B., Krueger, D., Anderson, R.M., Schoeller, D.A., & Binkley, N. (2017). Electrical properties assessed by bioelectrical impedance spectroscopy as biomarkers of age-related loss of skeletal muscle quantity and quality. The journals of gerontology. Series A, Biological sciences and medical sciences, 72(9), 1180-1186.
View publication via DOI: DOI:10.1093/gerona/glw225

Buehring, B., Krueger, D., Fidler, E., Gagnon, R., Heiderscheit, B., & Binkley, N. (2015). Reproducibility of jumping mechanography and traditional measures of physical and muscle function in older adults. Osteoporosis International, (2), 819-25.
View publication via DOI: DOI:10.1007/s00198-014-2983-z

Siglinsky, E., Krueger, D., Ward, R.E., Caserotti, P., Strotmeyer, E.S., Harris, T.B., Binkley, N., & Buehring, B. (2015). Effect of Age and Sex on Jumping Mechanography and Other Measures of Muscle Mass and Function. Journal of Muscoskeletal and Neuronal Interactions, 15(4):301-8.

Clynes, M.A., Edwards, M.H., Buehring, B., Dennison, E.M., Binkley, N., & Cooper, C. (2015). Definitions of sarcopenia: associations with falls and fracture in a population sample. Calcified Tissue International, 97(5):445-52.
View publication via DOI: DOI:10.1007/s00223-015-0044-z

Edwards, M.H., & Buehring, B. (2015). Novel approaches to the diagnosis of sarcopenia. Journal of Clinical Densitometry, 18(4):472-7.
View publication via DOI: DOI:10.1016/j.jocd.2015.04.010

Peterson, M., Buehring, B., Rush, P., Fitz, S., & Albertini, M. (2015). Paraneoplastic necrotizing myopathy in association with metastatic malignant melanoma: two case reports and a review of the literature. Case Reports in Clinical Pathology, 2(4):46-54.
View publication via DOI: DOI:10.3816/CCC.2007.n.020

Buehring, B. (2014). Past, present and future of muscle-bone interactions. Clinical Reviews in Bone and Mineral Metabolism, 12(2), 59-69.
View publication via DOI: DOI:10.1007/s12018-014-9167-4

Buehring, B., Krueger, D., Libber, J., Heiderscheit, B., Sanfilippo, J., & Binkley, N. (2014). Dual-energy X-ray absorptiometry measured regional body composition least significant change: Effect of region of interest and gender in athletes. Journal of Clinical Densitomotry, 17(1), 121-8.
View publication via DOI: DOI:10.1016/j.jocd.2013.02.012

Buehring, B., Krueger, D., & Binkley, N. (2013). Effect of including historical height and radius BMD measurement on sarco-osteoporosis prevalence. Journal of Cachexia, Sarcopenia and Muscle, 4(1), 47-54.
View publication via DOI: DOI:10.1007/s13539-012-0080-8

Lang, J. M., Wallace, M., Becker, J. T., Eickhoff, J. C., Buehring, B., Binkley, N., . . . McNeel, D. G. (2013). A randomized phase II trial evaluating different schedules of zoledronic acid on bone mineral density in patients with prostate cancer beginning androgen deprivation therapy. Clinical Genitourinary Cancer, 11(4), 407-415.
View publication via DOI: DOI:10.1016/j.clgc.2013.04.029

Buehring, B., Hind, J., Fidler, E., Krueger, D., Binkley, N., & Robbins, J. (2013). Tongue strength is associated with jumping mechanography performance and handgrip strength but not with classic functional tests in older adults. Journal of the American Geriatrics Society, 61(3), 418-422.
View publication via DOI: DOI:10.1111/jgs.12124

Buehring, B., Viswanathan, R., Binkley, N., & Busse, W. (2013). Glucocorticoid-induced osteoporosis: An update on effects and management. Journal of Allergy and Clinical Immunology, 132(5), 1019-1030.
View publication via DOI: DOI:10.1016/j.jaci.2013.08.040

Buehring, B., & Binkley, N. (2013). Myostatin - The Holy Grail for muscle, bone, and fat? Current Osteoporosis Reports, 11(4), 407-414.
View publication via DOI: DOI:10.1007/s11914-013-0160-5

Binkley, N., Krueger, D., & Buehring, B. (2013). What's in a name revisited: Should osteoporosis and sarcopenia be considered components of "dysmobility syndrome?" Osteoporosis International. Advance online publication.
View publication via DOI: DOI:10.1007/s00198-013-2427-1

Paparodis, R., Buehring, B., Pelley, E. M., & Binkley, N. (2013). A case of an unusual subtrochanteric fracture in a patient receiving denosumab. Endocrine Practice, 19(3), e64-68.
View publication via DOI: DOI:10.4158/ep12367.cr

Buehring, B., Krueger, D., Libber, J., Heiderscheit, B., Sanfilippo, J., Johnson, B., . . . Binkley, N (2013). Dual-energy X-ray absorptiometry measured regional body composition least significant change: Effect of region of interest and gender in athletes Journal of Clinical Densitometry. Advance online publication.
View publication via DOI: DOI:10.1016/j.jocd.2013.02.012

Lang, J. M., Wallace, M., Becker, J. T., Eickhoff, J. C., Buehring, B., Binkley, N., . . . Wilding, G. . . . McNeel, D. G. (2013). A randomized phase II trial evaluating different schedules of zoledronic acid on bone mineral density in patients with prostate cancer beginning androgen deprivation therapy. Clinical Genitourinary Cancer, 11(4), 407-415.
View publication via DOI: DOI:10.1016/j.clgc.2013.04.029

Dardevet, D., Marzetti, E., Dionne, I.J., Buford, T.W., Buehring, B., Manini, T.M., ... Ulfhake, B. (2012). Commentaries on Viewpoint: Muscle Atrophy is not always Sarcopenia. Journal of Applied Physiology, 113(4), 680-684.
View publication via DOI: DOI:10.1152/japplphysiol.00667.2012

Buehring, B., Kirchner, E., Sun, Z., & Calabrese, L. (2012). The frequency of low muscle mass and its overlap with low bone mineral density and lipodystrophy in individuals with HIV - a pilot study using DXA total body composition analysis. Journal of Clinical Densitometry, 15(2), 224-232.
View publication via DOI: DOI:10.1016/j.jocd.2011.10.003

Buehring, B., Belavy, D.L., Michaelis, I., Gast, U., Felsenberg, D., & Rittweger, J. (2011). Changes in Lower Extremity Muscle Function after 56 days of Bed Rest. Journal of Applied Physiology, 111(1), 87-94.
View publication via DOI: DOI:10.1152/japplphysiol.01294.2010

Buehring, B., Krueger, D., Binkley, N. (2010). Jumping mechanography: A potential tool for sarcopenia evaluation in older individuals. Journal of Clinical Densitometry, 13, 283-291.
View publication via DOI: DOI:10.1016/j.jocd.2010.04.002

Buehring, B., Krueger, D., Checovich, M., Gemar, D., Vallarta-Ast, N., Genant, H.K., & Binkley, N. (2010). Vertebral fracture assessment: impact of instrument and reader. Osteoporosis International, 21(3), 487-94.
View publication via DOI: DOI:10.1007/s00198-009-0972-4

Rittweger, J., Beller, G., Armbrecht, G., Mulder, E., Buehring, B., Gast, U., ... Felsenberg, D. (2010). Prevention of bone loss during 56 days of strict bed rest by side-alternating resistive vibration exercise. Bone, 46(1), 137-47.
View publication via DOI: DOI:10.1016/j.bone.2009.08.051

Binkley, N., & Buehring, B. (2009). Beyond FRAX: it's time to consider "sarco-osteopenia". Journal of Clinical Densitometry, 12(4), 413-416.
View publication via DOI: DOI:10.1016/j.jocd.2009.06.004

Binkley, N., Ramamurthy, R., Krueger, D., & Buehring, B. (2009). Advances in osteoporosis care for older adults. Clinical Geriatrics, 17(2), 35-40.

Blottner, D., Salanova, M., Puttmann, B., Schiffl, G., Felsenberg, D., Buehring, B., & Rittweger, J. (2006). Human skeletal muscle structure and function preserved by vibration muscle exercise following 55 days of bed rest. European Journal of Applied Physiology, 97(3), 261-271.
View publication via DOI: DOI:10.1007/s00421-006-0160-6

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