PROSPECTIVE STUDY OF OSTEOPOROSIS & RISK FACTORS IN JRA

这项建议的长期目标是降低骨量减少的风险。 和幼年类风湿性关节炎(JRA)患者的骨折。这个 迈向这一目标的第一步是描述 在JRA中识别和识别骨病，那些预测减少的危险因素 骨量。预防和治疗艾滋病的干预策略 骨量减少是从骨骼发育的过程中获得的 通过连续测量骨密度(BMD)。这个 这项提案的具体目标是：(1)确定患者是否 患有JRA的人骨骼生长和发育速度下降 比较对照组儿童的骨密度变化率；(2) 找出导致骨密度异常的因素和 JRA患者群体的新陈代谢；(3)骨的特征 通过连续测量骨的形成和吸收动力学 成骨细胞和破骨细胞活动的生化标记物。这个 JRA患者与对照组的骨密度变化将通过 协方差分析的性能。假定风险因素的影响 将通过单变量分析和构建一个 多变量模型。 这项提案的主要发起人Murray J.Favus博士是一位 骨代谢和骨病领域的资深研究员。 法乌斯博士将指导拉比诺维奇博士对骨骼疾病的研究 以及JRA患者骨质疏松的危险因素。卡里森博士， 第二赞助商，是一名生物统计学家，在 通过他的研究和他在机构的工作进行的临床研究 复审委员会和加州大学临床研究中心(CRC) 芝加哥。卡里森博士将指导拉比诺维奇博士伸展她的 数据分析领域的专业知识。在法弗斯博士的指导下 卡里森，拉比诺维奇博士将努力成为一名成功的独立医生 儿科风湿病和骨科的临床研究员 精神错乱。拉比诺维奇博士概述了一项正式的教学计划 包括报名参加由儿童权利中心赞助的名为《基本要领》的课程 临床研究“，通过参与罗伯特·伍兹·约翰逊 临床学者计划和注册生物统计学课程 由卡里森博士教授。本课程将增强拉比诺维奇博士的 了解卫生服务研究、医学伦理、研究设计、 生物统计学和结果研究。此外，拉比诺维奇博士将出席 加州大学每周一次的互动研讨会，题为《健康研讨会》 研究“，并继续积极参与与 骨骼工作组。 在传记中总结的拉比诺维奇博士的背景和经验 Sketch支持她参与指导临床科学家 发展计划。拉比诺维奇博士有独特的能力，包括正式的 通过攻读公共卫生硕士学位进行流行病学培训 在流行病学方面。她拥有儿科风湿科的资格证书。 全面发展的临床医生和教师。她正在发展专业知识 骨科疾病领域。她的长期职业计划是追求自己的事业 在包含临床研究、教学和患者的学术医学中 关心。导师临床科学家发展奖将帮助Dr。 拉比诺维奇努力发展成为一名独立的调查员。

The long-term goal of this proposal is to reduce the risk for osteopenia and fracture in patients with juvenile rheumatoid arthritis (JRA). The first steps toward this goal are to characterize the natural history of bone disease in JRA and identify, those risk factors which predict reduced bone mass. Strategies for intervention in the prevention and treatment of osteopenia will be derived from the course of skeletal development obtained through sequential measurements of bone mineral density (BMD). The specific aims of this proposal are; (1) to determine whether patients with JRA have a decreased rate of skeletal growth and development by comparing rates of change in BMD to a control group of children; (2) to identify the factors that contribute to abnormalities in bone density and metabolism in the JRA patient population; (3) to characterize bone formation and resorption dynamics through sequential measurement of bone biochemical markers of osteoblastic and osteoclastic activities. The change in BMD in JRA patients versus controls will be compared by performance of analysis of covariance. The impact of putative risk factors on BMD will be evaluated by univariate analysis and by construction of a multivariable model. The primary sponsor for this proposal, Dr. Murray J. Favus, is an accomplished researcher in the field of bone metabolism and bone diseases. Dr. Favus will guide Dr. Rabinovich in the investigation of bone disorders and risk factors for osteoporosis in patients with JRA. Dr. Karrison, the secondary sponsor, is a biostatistician with extensive experience in clinical studies via his research and his work with the Institutional Review Board and the Clinical Research Center (CRC) at the University of Chicago. Dr. Karrison will guide Dr. Rabinovich as she extends her expertise in the field of data analysis. Under the tutelage of Drs. Favus and karrison, Dr. Rabinovich will strive to become a successful independent clinical investigator in the fields of pediatric rheumatology and bone disorders. Dr. Rabinovich has outlined a plan for formal didactic teaching including enrollment in a course sponsored by the CRC entitled "Essentials of Clinical Research", through participation in the Robert Woods Johnson Clinical Scholars Program and by enrollment in a biostatistics course taught by Dr. Karrison. This coursework will augment Dr. Rabinovich's knowledge in health services research, medical ethics, research design, biostatistics and outcome studies. In addition, Dr. Rabinovich will attend weekly interactive seminars at the U of C entitled "Seminars in Health Studies" and remain an active participant in a series of meetings with the Bone Working Group. Dr. Rabinovich's background and experience summarized in the biographical sketch support her participation in the Mentored Clinical Scientist Development program. Dr. Rabinovich has unique abilities, including formal training in epidemiology through the pursuit of a Master's in Public Health in epidemiology. She is board certified in a pediatric rheumatology, a well rounded clinician and teacher. She is developing expertise in the field of bone disorders. Her long term career plans are to pursue a career in academic medicine encompassing clinical research, teaching, and patient care. The Mentored Clinical Scientist Development Award will aid Dr. Rabinovich as she strives to develop into an independent investigator.