MRC National Survey of Health and Development: hip and spine morphologies from DXA images related to osteoporosis, osteoarthritis and low back pain

点击翻译按钮获取中文摘要

The shapes of our hips and the lower part of our back largely determine our flexibility and how easily we can move. Diseases such as osteoarthritis not only destroy the tissues in our joints but also change the shape of the joint, which is at least part of the reason sufferers become stiff and movement becomes painful. In other situations, the shape of the joint may make it more likely that falling leads to a fracture of the hip, for instance, when bones are weakened by osteoporosis. We have also recently shown that we each have our own distinctive shape to our lower backs and we are currently exploring whether the particular shape might make back pain or injury more likely. What we don't know, however, is what determines the shapes of our joints. How much is inherited? How much depends on what we eat; or our lifestyle - active or sedentary, or other diseases from which we may suffer as we get older?A wonderful resource is available to help us start to tackle these questions: the National Survey of Health and Development. This is a group of individuals who have been studied at intervals from when they were born in 1946. They have recently had x-ray images taken of their hips and their spine and we want to make measurements of the shape of the hip and the curviness of the spine. We do this using a computer program we have written to perform a process called 'Shape Modelling'. This software is trained to identify the shape of interest (hip or spine) and from lots of images uses a mathematical technique to look for features that describe the shape. This gives a numerical description of the shape that we can then compare with other measurements. In the National Survey of Health and Disease a wealth of social, behavioural and biomedical data have been collected over the years, although this is the first time that x-ray pictures of the joints have been taken. By looking to see if individuals with particular features to the shape of their hips, for instance, have other things in common (for example: male or female, low birth weight, obesity) we can begin to see whether these things might have affected the way the joints have acquired the shape they have. This, in turn, might help us to understand why some people are more prone to osteoarthritis, osteoporosis or low back pain.At present, we do not understand what starts off these disorders. The results from this study might give us some clues to this and from there we can begin to work out if it is possible to avoid some of the 'risk factors'. This might be possible using existing or new drugs but, more importantly, might equally be a matter of diet or exercise.