Multi-Center Osteoarthritis Study

描述(申请人提供)：骨性关节炎(OA)是最常见的 关节炎的形式以及膝盖或臀部的疾病是导致 残疾。大多数膝关节和髋关节骨性关节炎的流行病学研究都集中在 放射学疾病，但有症状的骨性关节炎应该是一个主要的研究重点 预防骨性关节炎，因为症状性疾病会导致残疾，并具有可怕的 对社会和公共卫生的影响。骨质疏松症可能是可以预防的，但只是一个 已确定的风险因素数量有限，主要是不可更改的，甚至 尽管风险因素可以改变，例如特定的活动、肌肉无力、 本体感觉缺陷、微量营养素缺乏和结构性因素 并可能对疾病风险产生重大影响。预防 机会是最相关的，最有可能被以下人员利用 已经患有疾病或感染风险最高的人。 这项建议将四种新方法引入到流行性感冒的流行病学研究中。 膝骨性关节炎：L.A专注于症状性疾病，2.全面 评估风险因素，包括可修改的风险因素，3.重点关注那些 将真正从预防机会中受益，那些已经拥有 疾病或那些感染这种疾病的高危人群以及4.成立为 比以前使用的更全面和更可重复性的成像 包括最先进的射线照相技术和核磁共振成像。MRI提供了丰富的 关于结构因素的信息，在这些因素中，异常可能影响 疾病。 这项研究的总体目标是纵向评估这些影响 三组因素：生物力学因素(蹲、跪、楼梯 攀岩，穿高跟鞋，股四头肌无力和本体感觉 骨和结构因素(骨密度、骨髓和半月板 MRI上的病变)和微量营养素缺乏(维生素C、E和D) 膝关节骨性关节炎的症状和X线表现的发生和发展 以人口为基础的男性和女性样本，年龄在50到79岁之间。虽然重点是 这个项目是膝关节骨性关节炎，我们还纳入了髋关节骨性关节炎的研究。 我们建议招募一个以社区为基础的样本，包括3000名可能 要么患有膝骨性关节炎，要么处于骨性关节炎的高危状态。高危人群将包括 那些超重的人，有膝盖症状的人和有 膝盖受伤或手术。受试者将根据症状进行评估 问卷、X光片和核磁共振？S将接受为期36个月的随访。 症状性或放射性骨性关节炎的发展或进展。分析将 重点研究这些重要风险因素与骨性关节炎结局的关系。 这项大型的、多方面的研究提供了明确的解决 对重大疾病的发展或进展具有潜在重要风险的因素 使疾病失效，并提供对疾病生物学和 潜在的疾病预防机会。

DESCRIPTION (provided by applicant): Osteoarthritis (OA) is the most common form of arthritis, and disease in the knee or hip are leading causes of disability. Most epidemiologic studies of knee and hip 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, wearing high heeled shoes, quadriceps weakness and proprioceptive deficits), bone and 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. Although the focus of this project is knee OA, we also incorporate a study of hip OA. 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 and 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 study 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 disease prevention.