People with osteoporosis worries soon might have to look no farther than their feet to assess their risk. A new technique using Raman spectroscopy and toenail clippings could predict patients’ risk for bone disease. Osteoporosis is a weakening of the bones that can result in difficult-to-heal breaks. The disease now is estimated to affect 200 million people worldwide; in the US alone, more than 60 million women over the age of 50 are at risk. “Underdiagnosis is a major problem in osteoporosis today, with just 12 to 24 percent of at-risk women tested in the US,” said Mark Towler, a professor of biomedical materials engineering science at the Inamori School of Engineering at Alfred University. “The health economic cost of the 294,000 hip fractures in the US in 2005 was $6 billion.” Considering these figures, Towler set out to find an affordable and accurate test to screen for osteoporosis, and it wasn’t long before he turned to Raman spectroscopy, which he had found can detect chemical changes in nails. “Working with clinicians during my tenure at the University of Limerick [in Ireland], one clinician pointed out that patients suffering from osteoporosis often exhibit ‘floppy’ fingernails, so I looked at a way of measuring this,” Towler said. “Mechanical testing did show a difference between nails sourced from healthy and osteoporotic patients. I surmised that we could pick up this chemical change using Raman spectroscopy.” Towler explained that the test created by his research team at the University of Limerick uses Raman spectroscopy to determine fracture risk by evaluating the presence of certain proteins in the sample. The presence and extent of these proteins measure the quality of the protein phase of the subject’s bones. His team’s preliminary studies have shown that the test is a clinically useful predictor of future hip fractures more than a decade in advance. By identifying at-risk women at an earlier age, the test could produce significant cost savings in medical care. The findings led to the formation of Crescent Diagnostics of Dublin, a company that hopes to launch its new Bone Quality Test within the next year and to expand into the US market within the next 18 months, pending FDA approval. Crescent recently secured more than $2 million in venture capital funding, which will be used to complete a range of clinical trials to prove the test’s efficacy, Towler said.