Dr Marian Schini
MD, PhD, FHEA
Clinical Medicine, School of Medicine and Population Health
Senior Clinical Research Fellow in Bone Metabolism
+44 114 215 9698
Full contact details
Clinical Medicine, School of Medicine and Population Health
Metabolic Bone Centre Sorby Wing
Northern General Hospital
Herries Road
Sheffield
S5 7AU
- Profile
-
For enquiries please contact - SMPH-West-Operational@sheffield.ac.uk
I graduated from the Medical school of the University of Patras in Greece in 2005. After 4 years of training in Internal Medicine and 4 years in Endocrinology and Diabetes, I successfully obtained my CCT in Endocrinology and Diabetes in 2014. I have been working as a clinical research fellow for the University of Sheffield since 2015, with an interest in osteoporosis and calcium metabolism disorders. During this time, I undertook a PhD focusing on the prevalence and natural history of normocalcaemic hyperparathyroidism and hypoparathyroidism, two disorders of calcium metabolism. This project was funded by The Medical Research Council Versus Arthritis Centre for Integrated Research into Musculoskeletal Ageing and the Osteoporosis 2000 Support Group.
After completing my PhD in 2020, I was appointed as an NHS consultant at the Metabolic Bone Centre at Sheffield Teaching Hospitals, but maintained my role as a fellow with the University of Sheffield, to pursue my research interest in bone metabolism further.
I have been involved in several research projects in collaboration with researchers from the University of Sheffield, national but also international higher institutions. These projects have led to a number of publications and awards. I am the primary investigator for the POSE study (PINP and Osteoporosis in Sheffield Evaluation), a project aiming to investigate the use of PINP to monitor osteoporosis treatment in clinical practice by non-specialist practitioners. I am also the lead investigator in studies evaluating current osteoporosis treatments further, like denosumab and zoledronic acid. I have supported and continue to support a number of clinical trials as both a primary and sub-investigator. Some of these studies are on rare disorders of bone metabolism like X-linked hypophosphataemia and osteogenesis imperfecta, for which I have developed a special interest.
- Research interests
-
My research interests are osteoporosis, calcium metabolism disorders and rare bone metabolism disorders like X-linked hypophosphataemia and hypophosphatasia.
My PhD work was around the prevalence and natural history of normocalcaemic hyperparathyroidism and hypoparathyroidism. This project provided some further understanding of these two newly described conditions which can help in their monitoring and treatment. Due to my interest and growing experience in these disorders, I was asked to assist in preparing the next international guidelines on normocalcaemic hyperparathyroidism
I was also involved in a number of systematic reviews and meta-analyses to evaluate the risk of fractures in patients with different chronic conditions like Parkinson’s disease and diabetes mellitus. These studies were performed in collaboration with ScHARR and the team of Dr Steve Cummings in the University of California.
Throughout the years, I provided support and continue to support various clinical trials around bone metabolism like:
- Primary investigator in the clinical trial: ‘The BUR02 study: A Phase 3b Open-label Study of the Anti-FGF23 Antibody, Burosumab (KRN23) in Adult Patients with X-linked Hypophosphatemia (XLH)
- Sub-investigator in the clinical trial “TOPaZ: Treatment of Osteogenesis Imperfecta with Parathyroid hormone and Zoledronic acid”
- Sub-investigator in the clinical trial “The STAG Study: Phase II Study of the Impact of AZD4017, A Selective 11β-HSD1 Inhibitor, on Biochemical Markers of Bone Turnover in Post-Menopausal Osteopenia”
- Sub-investigator in the clinical trial “AXLES: A Randomized, Double-Blind, Placebo-Controlled, Phase 3 Study to Assess the Efficacy and safety of KRN23 in Adults with X-linked Hypophosphatemia (XLH)”
- Sub-investigator in the “SeMS study: Double-blind, randomised, placebo-controlled trial on the effect of selenium supplementation on musculoskeletal health in older women”
- Publications
-
Show: Featured publications All publications
Featured publications
Journal articles
- The effect of denosumab treatment on osteoclast precursor cells in postmenopausal osteoporosis. Bone Reports, 13, 100457-100457.
- Normocalcemic hyperparathyroidism : study of its prevalence and natural history. The Journal of Clinical Endocrinology & Metabolism, 105(4). View this article in WRRO
All publications
Journal articles
- Evaluación del riesgo de fractura con FRAX y FRAXplus. Gaceta Médica de México, 160(4).
- 7867 Treatment-related changes in total hip bone mineral density and fracture risk reduction for drugs with different mechanisms of action: the FNIH-ASBMR-SABRE project. Journal of the Endocrine Society, 8(Supplement_1). View this article in WRRO
- A new FRAX model for Brazil. Archives of Osteoporosis, 18(1), 144.
- Increased fracture risk in Parkinson's disease – An exploration of mechanisms and consequences for fracture prediction with FRAX. Bone, 168, 116651-116651.
- Osteoporosis in men. Lancet Diabetes and Endocrinology.
- Utility of PINP to monitor osteoporosis treatment in primary care, the POSE study (PINP and Osteoporosis in Sheffield Evaluation). Bone, 116347-116347.
- Evaluation of estimated glomerular function (eGFR) versus creatinine clearance (CrCl) to predict acute kidney injury when using zoledronate for the treatment of osteoporosis.. Osteoporos Int.
- Physical function and mobility in adults with X-linked hypophosphatemia. Bone Reports, 14, 101002.
- Randomised controlled trial of nutritional supplement on bone turnover markers in Indian premenopausal women. Nutrients, 13(2).
- Normocalcaemic hyperparathyroidism (NPHPT) and primary hyperparathyroidism (PHPT): Least significant change (LSC) for adjusted serum calcium. European Journal of Endocrinology, 184(1), K7-K10. View this article in WRRO
- Establishing race-, gender- and age-specific reference intervals for pyridoxal 5’-phosphate in the NHANES population to better identify adult hypophosphatasia. Bone, 141. View this article in WRRO
- Albumin-adjusted calcium equation and reference interval for adjusted calcium. Data from the UK Biobank. Bone Reports, 13, 100347-100347.
- The effect of denosumab treatment on osteoclast precursor cells in postmenopausal osteoporosis. Bone Reports, 13, 100457-100457.
- Risks of hip and nonvertebral fractures in patients with CKD G3a-G5D: a systematic review and meta-analysis. American Journal of Kidney Diseases, 76(4), 521-532. View this article in WRRO
- Reference interval for albumin‐adjusted calcium based on a large UK population. Clinical Endocrinology. View this article in WRRO
- The risk of hip and non-vertebral fractures in type 1 and type 2 diabetes: A systematic review and meta-analysis update. Bone, 137. View this article in WRRO
- Response to letter to the editor: “Normocalcemic hyperparathyroidism: Study of its prevalence and natural history”. The Journal of Clinical Endocrinology & Metabolism, 105(7). View this article in WRRO
- The prevalence and natural history of normocalcaemic hypoparathyroidism in a United Kingdom referral population. Clinical Endocrinology. View this article in WRRO
- Normocalcemic hyperparathyroidism : study of its prevalence and natural history. The Journal of Clinical Endocrinology & Metabolism, 105(4). View this article in WRRO
- The risk of hip and non-vertebral fractures in patients with Parkinson's disease and parkinsonism : a systematic review and meta-analysis. Bone, 132. View this article in WRRO
- Rationale for the Application of RANKL Inhibition in the Treatment of Langerhans Cell Histiocytosis. The Journal of Clinical Endocrinology & Metabolism, 100(2), E282-E286.
- Cirrhosis but not neutropenia is associated with the development of infection in patients with chronic hepatitis C undergoing treatment with pegylated interferon-alpha and ribavirin. Journal of Viral Hepatitis, 21(9), 624-632.
- Cladribine therapy in adults with advanced Langerhans cell histiocytosis. Leukemia & Lymphoma, 54(7), 1541-1543.
- Brief Report: Adrenal autoimmunity in primary Sjögren's syndrome. Arthritis & Rheumatism, 64(12), 4066-4071.
- Serum Osteoprotegerin, RANKL, and Dkk-1 Levels in Adults with Langerhans Cell Histiocytosis. The Journal of Clinical Endocrinology & Metabolism, 97(4), E618-E621.
- The effects of denosumab on osteoclast precursors in postmenopausal women: a possible explanation for the overshoot phenomenon after discontinuation. Journal of Bone and Mineral Research.
- The relationship between treatment-related changes in total hip BMD measured after 12, 18, and 24 mo and fracture risk reduction in osteoporosis clinical trials: the FNIH-ASBMR-SABRE project. Journal of Bone and Mineral Research.
- Race-specific FRAX models are evidence-based and support equitable care: a response to the ASBMR Task Force report on Clinical Algorithms for Fracture Risk. Osteoporosis International.
- Update on fracture risk assessment in osteoporosis. Current Opinion in Endocrinology, Diabetes & Obesity.
- Pre-treatment bone mineral density (BMD) and the benefit of pharmacologic treatment on fracture risk and BMD change: analysis from the FNIH-ASBMR SABRE project. Journal of Bone and Mineral Research.
- Anti-fracture treatment efficacy by age. Journal of Bone and Mineral Research.
- A meta-analysis of previous falls and subsequent fracture risk in cohort studies. Osteoporosis International.
- Service evaluation of the metabolic bone centre primary hyperparathyroidism registry. Endocrine Abstracts.
- An overview of the use of the fracture risk assessment tool (FRAX) in osteoporosis. Journal of Endocrinological Investigation.
- Bone Turnover Markers: Basic Biology to Clinical Applications. Endocrine Reviews.
- A rare presentation of avascular necrosis of the femoral head and mild cardiomyopathy in a patient with 17-hydroxylase deficiency. Endocrine Abstracts.
- How to manage normocalcaemic hyperparathyroidism. Endocrine Abstracts.
- Classical and
non‐Classical Manifestations of Primary Hyperparathyroidism. Journal of Bone and Mineral Research.
- Effect of AZD4017, a Selective 11β-HSD1 Inhibitor, on Bone Turnover Markers in Postmenopausal Osteopenia. The Journal of Clinical Endocrinology & Metabolism.
- Physical function and physical activity in adults with X-linked hypophosphatemia. Osteoporosis International.
Conference proceedings papers
- The association between treatment-related differences in total hip bone mineral density change and fracture risk reduction for BMD measurement intervals of 12, 18 and 24 months: the FINH-ASBMR SABRE Project. JOURNAL OF BONE AND MINERAL RESEARCH, Vol. 38 (pp 240-240)
- Influence of age on the efficacy of pharmacologic treatments on fracture risk reduction and increases in BMD: Results from the FNIH-ASBMR SABRE Project. JOURNAL OF BONE AND MINERAL RESEARCH, Vol. 38 (pp 66-66)
- Influence of age on the efficacy of pharmacologic treatments on fracture risk reduction and increases in BMD: Results from the FNIH-ASBMR SABRE Project. JOURNAL OF BONE AND MINERAL RESEARCH, Vol. 38 (pp 10-11)
- Renal Safety Of Zoledronic Acid In Patients With Borderline Kidney Function At A Metabolic Bone Centre In The United Kingdom. JOURNAL OF BONE AND MINERAL RESEARCH, Vol. 37 (pp 271-271)
- Monitoring Bisphosphonate Treatment In Primary Care: PINP And Osteoporosis In Sheffield Evaluation (POSE Study). JOURNAL OF BONE AND MINERAL RESEARCH, Vol. 37 (pp 64-65)
- RENAL SAFETY OF ZOLEDRONIC ACID IN PATIENTS WITH BORDERLINE KIDNEY FUNCTION AT A METABOLIC BONE CENTRE IN THE UK. OSTEOPOROSIS INTERNATIONAL, Vol. 32(SUPPL 1) (pp S194-S195)
- MONITORING BISPHOSPHONATE TREATMENT IN PRIMARY CARE: PINP AND OSTEOPOROSIS IN SHEFFIELD EVALUATION (POSE STUDY). OSTEOPOROSIS INTERNATIONAL, Vol. 32(SUPPL 1) (pp S288-S288)
- Prevention and management of osteoporosis. Medicine
- SUN-622 The risk of hip and non-vertebral fractures in diabetes : a systematic review and meta-analysis update. Journal of the Endocrine Society, Vol. 4(Supplement_1). San Francisco, CA, USA, 28 March 2020 - 31 March 2020. View this article in WRRO
- THE RISK OF HIP AND NON-VERTEBRAL FRACTURES IN PARKINSON'S DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS. OSTEOPOROSIS INTERNATIONAL, Vol. 31(SUPPL 1) (pp S55-S55)
- NORMOCALCEMIC HYPERPARATHYROIDISM: STUDY OF THE PREVALENCE AND NATURAL HISTORY. OSTEOPOROSIS INTERNATIONAL, Vol. 31(SUPPL 1) (pp S192-S192)
- Normocalcaemic hyperparathyroidism (NPHPT) and primary hyperparathyroidism (PHPT): Least significant change (LSC) for adjusted serum calcium. JOURNAL OF BONE AND MINERAL RESEARCH, Vol. 35 (pp 55-55)
- The Risk of Hip and Non-Vertebral Fractures in Parkinson's Disease: A Systematic Review and Meta-Analysis. JOURNAL OF BONE AND MINERAL RESEARCH, Vol. 34 (pp 103-103)
- The Risk of Hip and Non-Vertebral Fractures in Chronic Kidney Disease: A Systematic Review and Meta-Analysis. JOURNAL OF BONE AND MINERAL RESEARCH, Vol. 34 (pp 25-25)
- NORMOCALCAEMIC HYPERPARATHYROIDISM: STUDY OF THE PREVALENCE AND NATURAL HISTORY IN A UNITED KINGDOM REFERRAL POPULATION. OSTEOPOROSIS INTERNATIONAL, Vol. 29 (pp 627-627)
- ADULT HYPOPHOSPHATASIA: A DISEASE WHERE THE CLINICAL COMPLICATIONS COULD BE AVOIDED BY CAREFUL EVALUATION OF PATIENTS. OSTEOPOROSIS INTERNATIONAL, Vol. 29 (pp 632-633) View this article in WRRO
- Normocalcaemic Hyperparathyroidism: Study Of The Prevalence And Natural History In A United Kingdom Referral Population. JOURNAL OF BONE AND MINERAL RESEARCH, Vol. 33 (pp 129-129)
- NORMOCALCAEMIC HYPERPARATHYROIDISM: PREVALENCE IN A UNITED KINGDOM REFERRAL POPULATION. OSTEOPOROSIS INTERNATIONAL, Vol. 27 (pp 649-650)
- ABSOLUTE NEUTRIPHIL COUNT IS NOT ASSOCIATED WITH THE DEVELOPMENT OF INFECTIONS IN PATIENTS WITH HCV HEPATITIS RECEIVING ANTI VIRAL TREATMENT. HEPATOLOGY, Vol. 52(4) (pp 807A-807A)
- The effect of denosumab treatment on osteoclast precursor cells in postmenopausal osteoporosis. Bone Reports, 13, 100457-100457.
- Teaching interests
-
I am engaged in various teaching sessions for undergraduate and postgraduate students and have supervised a number of research placement students, including a CIMA MRes student and visiting clinical fellows.
- Professional activities and memberships
-
I am a Fellow of the Higher Education Academy and a member of the Association of Medical Educators.
- Current projects
-
-
The use of PINP in a primary care setting to monitor osteoporosis (the POSE Study)
This is a project that I lead on and involves the assessment of a bone marker called PINP in a real-life setting in order to check whether patients that are monitored using this marker have better outcomes in terms of bone density, number of fractures and treatment persistence than the patients not monitored. This project is in collaboration with ScHARR and Professor Bo Abrahamsen in Denmark and has received a grant funding by Roche Diagnostics.
-
Osteoclast precursors in patients treated with denosumab
Denosumab is an anti-osteoporotic medication that has proven effective in preventing bone loss and reducing the incidence of fractures. However, on discontinuation of denosumab there is a rebound of bone turnover to 200% of pre-treatment baseline, which is associated with loss of the comparative gains in bone strength, and concerns have arisen amid cases reporting an increase in the incidence of osteoporotic fractures. The aim of this project, is to investigate the effect of denosumab on the osteoclast precursor population in order to elucidate the cellular mechanisms of this phenomenon.
-
Neutrophil migratory function in patients treated with zoledronic acid
Both statins and zoledronic acid target the same metabolic pathway, therefore we suspect the mechanism underlying the reduction in morbidity and mortality in patients with zoledronic acid may be related to an ameliorated function of neutrophils. This is an early stage study, aiming to see what the effect of zoledronic acid is on the migratory function of neutrophils and their ability to engulf and destroy bacteria.
-