Multicenter Osteoarthritis Study (MOST)

描述（由申请人提供）：骨关节炎（OA）是最常见的 膝关节炎和疾病是导致残疾的主要原因。 大多数膝关节骨性关节炎的流行病学研究都集中在放射学疾病，但 症状性OA应该是预防OA研究的主要焦点，因为 有症状的疾病会导致残疾， 健康影响。OA是可以预防的，但只有有限数量的 大多数不可改变的风险因素已经确定，即使可以改变， 风险因素，如特殊活动，肌肉无力，本体感受 缺乏、微量营养素缺乏和结构因素 并且可能显著影响疾病的风险。预防机会是 最相关，最有可能被那些已经患有疾病的人使用 或者是最有可能感染的人 该建议为流行病学研究引入了四种新方法， 膝骨关节炎：l. a关注症状性疾病，2.全面 风险因素的评估，包括可修改的，3。关注那些 将真正受益于预防机会，那些已经有 疾病或感染该疾病的高风险人群以及4.掺入 比以前使用的成像更全面和可再现 包括最先进的射线照相技术和MRI。MRI提供丰富的 关于异常情况可能影响 疾病 本研究的总体目标是纵向评价 三组因素：生物力学因素（蹲，跪，楼梯 攀爬、股四头肌无力和本体感受缺陷）、骨骼和结构 因素（骨密度、骨髓和MRI上的椎间盘病变）和 微量营养素缺乏症（维生素C、E和D）的发生率， 基于人群的症状性和影像学膝关节OA进展 50至79岁的男性和女性样本。 我们建议招募一个以社区为基础的3,000名男女样本， 患有膝关节骨性关节炎或有患骨性关节炎的高风险。高危人群包括 那些超重的人，那些有膝盖症状的人，或者那些有 膝盖受伤或手术。将对受试者进行症状评估 问卷调查，X光片和核磁共振成像并将随访36个月， 症状性或影像学OA的发展或进展。分析将 关注这些重要的危险因素与OA结局的关系。 这项针对膝关节OA患者的大型、多方面和全面的研究， 高风险的疾病，提供明确解决的关系， 对重大疾病的发展或进展具有潜在重要风险的因素 使疾病丧失能力，并为疾病生物学提供新的见解， 潜在的预防机会

DESCRIPTION (provided by applicant): Osteoarthritis (OA) is the most common form of arthritis and disease in the knee is a leading cause of disability. Most epidemiologic studies of knee OA have focused on radiographic disease, but symptomatic OA should be a major focus of studies on preventing OA, because symptomatic disease causes disability and has formidable societal and public health impacts. OA is potentially preventable, but only a limited number of mostly nonmodifiable risk factors has been identified, even though modifiable risk factors such as particular activities, muscle weakness, proprioceptive deficits, micronutrient deficiencies and structural factors have been proposed and may affect substantially the risk of disease. Prevention opportunities are most relevant and are most likely to be used by those who already have disease or who are at highest risk of getting it. This proposal introduces four new approaches into the epidemiologic study of knee osteoarthritis: l.a focus on symptomatic disease, 2. a comprehensive evaluation of risk factors including modifiable ones, 3. a focus on those who would really benefit from prevention opportunities, those who already have disease or those who are at high risk of getting it and 4. the incorporation of more comprehensive and reproducible imaging than has previously been used including, state of the art radiographic techniques and MRI. MRI provides rich information on structural factors in which abnormalities may affect the risk of disease. The overall objective of this study is to evaluate longitudinally the effects of three groups of factors: biomechanical factors (squatting,kneeling, stair climbing, quadriceps weakness and proprioceptive deficits), boneand structural factors (bone density,bone marrow and meniscal lesions on MRI) and micronutrient deficiencies (vitamin C, E and D) on the occurrence and progression of symptomatic and radiographic knee OA in a population-based sample of men and women aged 50 to 79. We propose to recruit a community-based sample of 3,000 men and women likely to either have knee OA or be at high risk of OA. High risk groups will include those who are overweight, those with knee symptoms or those with a history of knee injuries or operations. Subjects will be evaluated with symptom questionnaires, radiographs and MRI?s and will be followed 36 months for the development or progression of symptomatic or radiographic OA. Analyses will focus on the relation of these important risk factors and OA outcomes. This large, multifaceted and comprehensive study of persons with knee OA, or at high risk of disease, offers to address definitively the relation of potentially important risk factors to the development or progression of a major disabling disease and to provide new insights into disease biology and potential opportunities for prevention