Joan C. Lo, MD

People

Kaiser Permanente Division of Research
2000 Broadway
Oakland, CA 94612

(510) 891-3492 (phone)
joan.c.lo@kp.org
Kaiser Permanente Researcher Profiles

Joan C. Lo, MD, is a senior research scientist at the Kaiser Permanente Northern California Division of Research and physician with The Permanente Medical Group; a professor of Health Systems Science at the KP Bernard J Tyson School of Medicine; a volunteer clinical professor of medicine at the University of California, San Francisco (UCSF); and an assistant program director for the KP Oakland Internal Medicine Residency Program. Dr. Lo completed her medical training at Harvard Medical School, Brigham & Women's Hospital (Internal Medicine) and UCSF (Endocrinology). She is board certified in Internal Medicine, Endocrinology & Metabolism, and Lifestyle Medicine. Dr. Lo's research is focused on osteoporosis and fracture outcomes, obesity and cardiometabolic risk, polycystic ovary syndrome, endocrinologic complications of chronic disease, and Asian health. Her interests also include medical education, research mentoring, and women in medicine.

Current Position(s):

Research Scientist III, Division of Research, Kaiser Permanente Northern California
Clinical Professor (Volunteer), Department of Medicine, University of California, San Francisco
Professor of Health Systems Science, Kaiser Permanente Bernard J Tyson School of Medicine
Assistant Program Director, Kaiser Permanente Oakland Internal Medicine Residency

Section Affiliations:

Cardiovascular and Metabolic Conditions

Primary Research Interests:

Osteoporosis and fracture risk assessment
Complications of osteoporosis therapies
Obesity and cardiometabolic health
Polycystic ovary syndrome
Asian health

Studies

Calculator for Length of Use of Bisphosphonates (CLUB)

Despite the wide availability of bisphosphonate drugs that reduce fracture risk, treatment rates have fallen, attributable to concerns for atypical femoral fractures and osteonecrosis of the jaw. While risk/benefit ratios of bisphosphonate treatment for osteoporosis remain highly favorable in the first 3-5 years, fracture-prevention benefit wanes with longer treatment and risks of side effects increases. This study will estimate the risks/benefits of bisphosphonate drug holidays; determine the cost effectiveness of continuing vs discontinuing a bisphosphonate after 3 years; and develop and validate a risk factor calculator to guide decisions about length of bisphosphonate use.
Investigator: Lo, Joan
Funder: National Institute on Aging

Skeletal Health Outcomes among US Asian Women

The burden of osteoporosis has increased as the US population over age 65 years has increased. Ethnic diversity in the U.S. has also increased. This is the first large scale US study of fracture outcomes among Asians and ethnic subgroups that will inform ethnic-specific osteoporosis counseling and fracture prevention care. Among older women receiving care in an integrated healthcare system, we aim to compare differences in the incidence of hip, vertebral, and major osteoporotic fracture, between white and Asian women, including comparison between various Asian ethnicities; characterize the association between femoral neck BMD and hip, vertebral, humerus, and wrist fracture in Asian women and between ethnic subgroups; and examine the predictive accuracy of Fracture Risk Tools for Asian women and ethnic subgroups and to determine whether inclusion of Asian-specific fracture data improves fracture risk prediction for Asians.
Investigator: Lo, Joan
Funder: National Institute on Aging

Femur Fracture Outcomes Associated with Bisphosphonate Use

In clinical practice, bisphosphonate drugs are considered one of the main therapies for osteoporosis, based on strong clinical evidence of significant reduction in risk of hip, vertebral and non-vertebral fractures during the first 3-5 years of therapy. However, concerns have emerged regarding uncommon long term adverse outcomes in patients treated beyond this period. This study proposes to fill an important knowledge gap by examining the risk of atypical femur fracture in women who receive bisphosphonate treatment for less than 3 years compared to women who continue treatment beyond 3 years and to examine the association of long term continuation of bisphosphonate therapy and subsequent risk of atypical femur fracture.
Investigator: Lo, Joan
Funder: National Institute on Aging

Highlighted Publications

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Publications

Cardiovascular Disease Risk Factors Among Middle-Aged and Older Adult Vietnamese American Members of a Northern California Health Plan

Author(s): Haysbert, Donna B; Lo, Joan C; Ramalingam, Nirmala D; Gordon, Nancy P

Public Health Rep. 2023 Jan-Feb;138(1):123-130. Epub 2022-02-20.

Current Position(s):

Section Affiliations:

Primary Research Interests:

Studies

Calculator for Length of Use of Bisphosphonates (CLUB)

Skeletal Health Outcomes among US Asian Women

Femur Fracture Outcomes Associated with Bisphosphonate Use

Highlighted Publications

Publications

Cardiovascular Disease Risk Factors Among Middle-Aged and Older Adult Vietnamese American Members of a Northern California Health Plan

Prevalence of sleep-related problems and risks in a community-dwelling older adult population: a cross-sectional survey-based study

Prevalence of prediabetes and diabetes vary by ethnicity among U.S. Asian adults at healthy weight, overweight, and obesity ranges: an electronic health record study

Identifying modifiable obesogenic behaviors among Latino adolescents in primary pediatric care.

Effect of Medically Tailored Meals on Clinical Outcomes in Recently Hospitalized High-Risk Adults

Ethnic diversity and burden of polycystic ovary syndrome among US adolescent females

Differential Cardiometabolic Risk Factor Clustering Across U.S. Asian Ethnic Groups

The Prevalence of Elevated Alanine Aminotransferase Levels Meeting Clinical Action Thresholds in Children with Obesity in Primary Care Practice

Description of Major Osteoporotic Fractures in Women with Invasive Breast Cancer Who Received Endocrine Therapy

Progression of atypical femur stress fracture after discontinuation of bisphosphonate therapy

Pearls from a Clinician-Researcher in an Integrated Health care Delivery System

The Risks of Polycystic Ovary Syndrome and Diabetes Vary by Ethnic Subgroup Among Young Asian Women

Ten-year Thyroid Cancer Incidence in an Integrated Healthcare Delivery System

Variation in fracture risk estimation among East Asian women

A prospective study of lifestyle factors and bone health in breast cancer patients who received aromatase inhibitors in an integrated healthcare setting

Understanding the Uptake of Digital Technologies for Health-Related Purposes in Frail Older Adults

Risk of complete atypical femur fracture with Oral bisphosphonate exposure beyond three years

Bisphosphonate Treatment Beyond 5 Years and Hip Fracture Risk in Older Women

Bone Mineral Density in Older U.S. Filipino, Chinese, Japanese, and White Women

Bruce Ettinger, MD

Establishing a Graduate Medical Education Task Force for the American Medical Women's Association

How Should We Counsel Asian Americans about Fracture Risk?

The Relationship of Diagnosed Acne and Weight Status in Adolescent Girls

The effect of frequent hemodialysis on matrix metalloproteinases, their tissue inhibitors, and FGF23: Implications for blood pressure and left ventricular mass modification in the Frequent Hemodialysis Network trials

The Epidemiology of Metatarsal Fractures Among Older Females With Bisphosphonate Exposure

Cardiac valvular abnormalities associated with use and cumulative exposure of cabergoline for hyperprolactinemia: the CATCH study

Statin Therapy and Risk of Incident Diabetes Mellitus in Adults With Cardiovascular Risk Factors

Longitudinal Evolution of Markers of Mineral Metabolism in Patients With CKD: The Chronic Renal Insufficiency Cohort (CRIC) Study

Determinants of Oral Bisphosphonate Use Beyond 5 Years

No Association Between Bone Mineral Density and Breast Arterial Calcification Among Postmenopausal Women

Serum bone markers and risk of osteoporosis and fragility fractures in women who received endocrine therapy for breast cancer: a prospective study

Don't Fall for That: A Residency Curricular Innovation about Fall Prevention

Atypical femur fracture incidence in women increases with duration of bisphosphonate exposure

Aggregation of Asian-American subgroups masks meaningful differences in health and health risks among Asian ethnicities: an electronic health record based cohort study

Vitamin D Status Among Older Women Initiating Osteoporosis Therapy

Depot Medroxyprogesterone Acetate, Oral Contraceptive, Intrauterine Device Use, and Fracture Risk

Secular Trends in Long-Term Oral Bisphosphonate Use

Association Between Progression of Retinopathy and Concurrent Progression of Kidney Disease: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study

Serum Sex Hormones and the Risk of Fracture across the Menopausal Transition: Study of Women's Health Across the Nation

Using Pharmacy Data and Adherence to Define Long-Term Bisphosphonate Exposure in Women

Urinary N-Telopeptide as Predictor of Onset of Menopause-Related Bone Loss in Pre- and Perimenopausal Women

The Association Between Change in Serum Bicarbonate and Change in Thyroid Hormone Levels in Patients Receiving Conventional or More Frequent Maintenance Hemodialysis

Recurrence after hospitalization for acute coronary syndrome among HIV-infected and HIV-uninfected individuals

The Association of Polycystic Ovary Syndrome and Gestational Hypertensive Disorders in a Diverse Community-Based Cohort

Understanding functional and social risk characteristics of frail older adults: a cross-sectional survey study

Changes in bone mineral density in women with breast cancer receiving aromatase inhibitor therapy

Changes in Biomarker Profile and Left Ventricular Hypertrophy Regression: Results from the Frequent Hemodialysis Network Trials

Contemporary rates and correlates of statin use and adherence in nondiabetic adults with cardiovascular risk factors: The KP CHAMP study

Trends in bisphosphonate initiation within an integrated healthcare delivery system

Thyroid function in end stage renal disease and effects of frequent hemodialysis

Racial and ethnic differences in hip fracture outcomes in men

Teaching Nutrition in Graduate Medical Education: An Interactive Workshop

Predicting Adherence and Persistence with Oral Bisphosphonate Therapy in an Integrated Health Care Delivery System

Predicting Hypertension Among Children With Incident Elevated Blood Pressure

Hyperprolactinemia in end-stage renal disease and effects of frequent hemodialysis

Racial-Ethnic Differences in Fall Prevalence among Older Women: A Cross-Sectional Survey Study

Changing Patterns in Oral Bisphosphonate Initiation in Women between 2004 and 2012

Innovative partnerships to advance public health training in community-based academic residency programs

Risk of Type 2 Diabetes Mellitus following Gestational Diabetes Pregnancy in Women with Polycystic Ovary Syndrome

Applying ethnic-specific bone mineral density T-scores to Chinese women in the USA

Urinary N-Telopeptide and Rate of Bone Loss Over the Menopause Transition and Early Postmenopause

Mortality following hip fracture in Chinese, Japanese, and Filipina women

Accuracy of the Atherosclerotic Cardiovascular Risk Equation in a Large Contemporary, Multiethnic Population

The association of race/ethnicity and risk of atypical femur fracture among older women receiving oral bisphosphonate therapy

Change in Weight Status and Development of Hypertension

Obesity Severity, Dietary Behaviors, and Lifestyle Risks Vary by Race/Ethnicity and Age in a Northern California Cohort of Children with Obesity

Retinopathy and the Risk of Cardiovascular Disease in Patients With Chronic Kidney Disease (from the Chronic Renal Insufficiency Cohort Study)

Comparing US paediatric and adult weight classification at the transition from late teenage to young adulthood

Gestational Thyrotoxicosis, Antithyroid Drug Use and Neonatal Outcomes within an Integrated Healthcare Delivery System

Serum 25 Hydroxyvitamin D, Bone Mineral Density and Fracture Risk Across the Menopause

Trends in mortality following hip fracture in older women