bone health research

Bone Health Research

Research exploring the bone health of Calgarians is taking place at the Dr. David Hanley Osteoporosis Centre and our affiliated Bone Imaging Laboratory at the University of Calgary’s McCaig Institute for Bone and Joint Health.  For over a decade researchers from the Bone Imaging Laboratory have examined the bone health and bone quality of individuals with varying levels of bone mineral density and bone strength. Participants involved in the various research studies range from healthy strong individuals including national and international athletes, to elderly people with osteoporosis. 

Some of our priority areas for research are:

  • Effects of vitamin D supplementation and other nutritional approaches upon bone strength.
  • Determinants of bone microarchitecture that lead to fracture.
  • Determining the perspectives, preferences and needs of people with osteoporosis
  • Development of new and innovative ways of delivering osteoporosis care
  • Studying potential treatments that could be offered earlier in life to prevent fractures in later life
  • Detection and characterization of rare bone disorders

Interested in getting involved?

If you would like to be considered for participation in a research study, contact us at:

 * This email address is being protected from spambots. You need JavaScript enabled to view it. (clinical studies) or  

 * This email address is being protected from spambots. You need JavaScript enabled to view it. (imaging studies) to find out how to begin.

Cutting-edge research requires investment! If you would like to support bone research, contact us at This email address is being protected from spambots. You need JavaScript enabled to view it.


Details about our active research activities

Experiences and outcomes of patients who attend our Self Consult Program check out the program here!

Since it started in 2016, more than 100 people have attended our osteoporosis group consultation (aka the ‘Self Consult Program’) and agreed to participate in research. We have been collecting data about people’s experience with this group program, and how this compares to a traditional one-on-one consultation with a specialist. We have found that the program is highly rated by patients and allows us to see a greater number of patients at the DHOC (and more quickly). We have also found that attending the Self Consult Program empowers people to confidently make decisions about whether or not to start osteoporosis treatment, and almost all patients are still confident with their decisions a year after the consultation.

Experiences of patients and physicians with virtual care for osteoporosis

The COVID-19 pandemic limited our ability to provide in-person care at the DHOC in the first half of 2020. As a result, we began offering virtual appointments via telephone and Zoom video conference. We have just started a new study to assess the experiences of patients and our osteoporosis physicians with virtual consultations at the DHOC.

You may be invited to enrol in this study if you attend either a virtual or in-person appointment at the DHOC in 2020.

NEW for 2022! For patients who wish to transition off of their denosumab (Prolia) therapy

Denosumab is a common osteoporosis medication that should not be stopped abruptly as it may lead to rapid bone loss and fracture.  We are partnering with the Bone Imaging Lab to study the effects of zoledronic acid infusions as a means to help patients safely discontinue their denosumab treatment.  Contact us at This email address is being protected from spambots. You need JavaScript enabled to view it. if you are interested in more information or participation.

Effects of high-dose vitamin D supplementation on bone density and bone microarchitecture

Dr. Billington is part of the team at the Bone Imaging Laboratory (link to Bone Lab website) who recently undertook a three-year randomized controlled trial evaluating the effects of high-dose vitamin D on bone health. The research team found that, when given to healthy adults who were not vitamin D deficient to begin with, high doses of vitamin D (4000 IU or 10,000 IU every day) did not have any benefits to the skeleton compared to a lower dose of 400 IU/day. In fact, the higher doses might actually be bad for the bones, but more research is needed on this.

This study is complete, but the team is continuing to analyze and publish data.

Predicting hip fractures using state-of-the-art imaging

Along with researchers at the Bone Imaging Laboratory, Dr. Billington is involved in a study which is trying to determine whether we can identify people at the highest risk of hip fracture using a state-of-the-art imaging technique called ‘high resolution peripheral quantitative computed tomography’.

People who have had a recent hip fracture are eligible to enrol in this study.

Preventing Osteoporosis With Early Recognition (POWER) Program

Dr. Billington is working with Dr. Prism Schneider of orthopedic surgery, who is leading a study to identify people who have recently had a fracture and ensure that these people receive an assessment of their risk of future fracture and an opportunity for treatment if their risk of having another fracture is high.  

People who have had a recent fracture and been seen by a doctor at the Foothills Medical Centre Cast Clinic are eligible to enrol in this study.

Building a fracture-free future Program

We are in the early phases of investigating possible treatments that women could receive around the time of menopause to help preserve their bone density and lower their risk of fracture later in life. At the moment, we are developing a survey and focus groups to learn more about whether our patients, other doctors, and the general public think that this is an important area of research.

We hope to start enrolling participants in this study very soon.

Facilities and Equipment at the Bone Imaging Laboratory

Located at the McCaig Institute for Bone and Joint Health at the University of Calgary, the Bone Imaging Laboratory uses state-of-the-art equipment to examine bone health, including dual x-ray absorptiometry (DXA) and high resolution computed tomography (CT).

dxa scanner

Dual x-ray absorptiometry (DXA) scanner


Hip scan



High resolution computed tomography scanner (HR-pQCT)



Lower leg (tibia) scan

Additional Information about the Bone Imaging Laboratory

Many of our research studies require volunteers, and we welcome interested people to contact the research team directly. More detailed information about bone research in Calgary is available at the Bone Imaging Laboratory and the McCaig Institute for Bone and Joint Health websites.


Contact information

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

Publications from our team in 2021

Reid IR, Billington EO. Drug Therapy for Osteoporosis in Older Adults. The Lancet 2022; 399:1080-1092. 

Billington EO, Mahajan A, Benham JL, Raman M. Effects of probiotics on bone mineral density and bone turnover: A systematic review. Crit Rev Food Sci Nutr 2021. DOI: 10.1080/10408398.2021.1998760

Riar S, Feasel AL, Aghajafari F, Symonds CJ, Kline GA, Billington EO. Comparison of 2 fracture risk estimation processes in Alberta: a cross-sectional chart review. CMAJ Open 2021; 9:E711-E717. 

Billington EO, Leslie WD, Brown JP, Prior JC, Morin SN, Kovacs CS, Kaiser SM, Lentle BC, Anastassiades T, Towheed T, Kline GA. Simulated Effects of Early Postmenopausal Bone Mineral Density Preservation on Long-term Fracture Risk: A Feasibility Study. Osteoporos Int 2021;32:1313-1320. Impact factor: 3.591.

Kline GA, Morin SN, Lix LM. Leslie WD.  Divergent patterns of anti-fracture medication use following fracture on therapy: a population-based cohort study.  J Clin Endocrinol Metab 2021;107(2):491-9.

Liu CS, Feasel AL, Kline GA, Billington EO. Pharmacotherapy decisions among postmenopausal women attending a group medical consultation or a one-on-one specialist consultation at an osteoporosis center. Osteoporos Int 2021;32:1421-1427. Impact factor: 3.591. 

Kline GA, Morin S, Lix L, Leslie WD.  Patient outcomes in the years after a DXA-BMD treatment monitoring test: improved medication adherence but too little too late? J Bone Min Res 2021;36(8):1425-31.

Kline GA, Morin SN, Feldman S, Lix LM, Leslie WD. Diminishing value from multiple serial bone densitometry in women receiving anti-resorptive medication for osteoporosis. The Journal of Clinical Endocrinology & Metabolism. 2021 106(9):2718-25.

Publications from our team in 2020

Safety of high-dose vitamin D supplementation: secondary analysis of a randomized controlled trialBillington EO, Burt LA, Rose MS, Davison EM, Gaudet S, Kan M, Boyd SK, Hanley DA.  J Clin Endocrinol Metab. 2000;105(4)

Postural balance effects associated with 400, 4000 or 10,000 IU vitamin D3 daily for three years: a secondary analysis of a randomized clinical trial. Burt LA, Gabel L, Billington EO, Hanley DA, Boyd SK. Nutrients 2020 12(2):527

At odds about the odds: women's choices to accept osteoporosis medications do not closely agree with physician-set treatment thresholds Billington EO, Feasel AL, Kline GA.  J Gen Internal Med. 2020;35(1):276-282.

Effect of high-dose vitamin D supplementation on peripheral arterial calcification: secondary analysis of a randomized clinical trial Billington EO, Burt LA, Plett R, Rose MS, Boyd SK, Hanley DA. Osteoporosis Int 2020

Longitudinal bone microarchitectural changes are best detected using image registration Kemp TD, de Bakker CMJ, Gabel L, Hanley DA, Billington EO, Burt LA, Boyd SK. Osteoporosis Int 2020

Parathyroid hormone-dependent familial hypercalcemia with low measured PTH levels and a presumptive novel pathogenic mutation in CaSR. Mahajan A, Buse J, Kline GA. Osteoporosis Int 2020;31(1)203-7.

Publications from our team in 2019

Effect of high-dose vitamin D supplementation on volumetric bone density and bone strength: a randomized clinical trial Burt LA, Billington EO, Rose MS, Raymond DA, Hanley DA, Boyd SK. JAMA 2019;322(8):736

Fibroblast growth factor 23 levels decline following sleeve gastrectomy Billington EO, Murphy R, Gamble GD, Callon K, Davies N, Plank LD, Booth M, Reid IR.  Clin Endocrinol 2019;91(1):87

Skeletal fluorosis in a resettled refugee from Kakuma refugee camp Fabreau G, Bauman P, Whitford G, Kennel KA, Coakley AL, Johnston K, Gifford J, Sadrzadeh H, Whyte M, Kline GA. Lancet 2019;393(10168):223

Phosphate matters when investigating hypercalcemia: a mutation in SLC34A3 causing HHRH Tang AR, Hinz LE, Khan A, Kline GA.  Endocrin Diab Metab Case Reports 2019 jul 26

Fracturing systemic skeletal histiocytosis of unknown type: a novel metabolic bone disease Saini R, diFrancesco LM, Johnston K, Khan A, Kline GA. Osteoporosis Int 2019 May 30