Structural Bone Disease in Chronic Renal Insufficiency

慢性肾功能不全的结构性骨病

基本信息

  • 批准号:
    7255726
  • 负责人:
  • 金额:
    $ 54.59万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2003
  • 资助国家:
    美国
  • 起止时间:
    2003-08-15 至 2009-06-30
  • 项目状态:
    已结题

项目摘要

DESCRIPTION (provided by applicant) Renal osteodystrophy (ROD) is an early and universal disorder of bone metabolism in chronic renal insufficiency (CRI). As CRI progresses, abnormal bone metabolism results in sclerosis of trabecular bone, thinning of cortical bone and increased cortical porosity. Despite widespread ROD therapies, fracture rates on dialysis are markedly increased. CRI also results in gonadal dysfunction. Estrogen deficiency and ROD have similar detrimental effects on cortical bone loss, but opposing effects on trabecular bone. Unlike traditional densitometric measures of bone mass, peripheral quantitative computed tomography (pQCT) permits discrete assessment of trabecular and cortical bone density and dimensions, and bone strength can be reliably estimated. PQCT is an ideal tool to study the skeletal effects of CRI. The NIDDK recently established the Chronic Renal Insufficiency Cohort (CRIC) study to determine risk factors for CRI progression and cardiovascular disease in mild to severe CRI. This prospective cohort, ages 21-74 years, will undergo annual visits, providing an unparalleled opportunity to determine the effects of CRI on bone structure. The hypotheses of this ancillary bone study are that (a) cortical bone volume and density are significantly decreased in CRI, resulting in early and substantial reductions in bone strength, and (b) the progression of cortical and trabecular bone loss is associated with renal dysfunction, hyperparathyroidism, sex hormone deficiencies, decreased muscle strength, comorbidities, and concurrent medications. In healthy adults, bone structure and density undergo gender-specific changes with aging; therefore, this study requires a control group of similar age and gender. This prospective cohort study of bone structure in CRIC participants at the UPENN site will employ dual energy x-ray absorptiometry (DXA) and pQCT to assess bone dimensions, density and strength. The study will examine the effects of renal disease severity, hypogonadism, muscle strength, hyperparathyroidism, comorbid conditions and medications. The protocol will characterize sex hormone deficiencies in this cohort, determine the prevalence and incidence of vertebral fracture, examine baseline measures of bone turnover and regulators of osteoclastogenesis as predictors of bone loss, and will examine the utility of routine DXA in the assessment of ROD. Accurate characterization of bone structure in CRI is necessary to identify risk factors for fragility, and to evaluate potential therapies.
描述(由申请人提供) 肾性骨营养不良(Rod)是慢性肾功能不全(CRI)早期普遍存在的骨代谢紊乱。随着CRI的进展,异常的骨代谢导致骨小梁硬化、皮质骨变薄和皮质孔洞增加。尽管广泛使用Rod疗法,但透析时的骨折发生率明显增加。CRI还会导致性腺功能障碍。雌激素缺乏和Rod对皮质骨丢失的影响相似,但对松质骨的影响相反。与传统的骨量密度测量不同,外周定量计算机断层扫描(PQCT)允许对骨小梁和皮质骨密度和尺寸进行离散评估,并且可以可靠地估计骨强度。PQCT是研究CRI骨骼效应的理想工具。NIDDK最近建立了慢性肾功能不全队列(CRIC)研究,以确定轻度到重度CRI患者CRI进展和心血管疾病的危险因素。这一年龄在21-74岁之间的未来队列将接受年度检查,这将提供一个无与伦比的机会来确定CRI对骨结构的影响。这项辅助性骨研究的假设是:(A)CRI患者的皮质骨体积和密度显著减少,导致早期和实质性的骨强度下降,(B)皮质和骨小梁丢失的进展与肾功能障碍、甲状旁腺功能亢进、性激素缺乏、肌肉力量下降、合并疾病和药物治疗有关。在健康的成年人中,骨结构和密度随着年龄的增长而发生性别特有的变化;因此,本研究需要年龄和性别相似的对照组。这项对宾夕法尼亚大学CRIC参与者骨结构的前瞻性队列研究将使用双能量X射线吸收测量仪(DXA)和pQCT来评估骨尺寸、密度和强度。这项研究将检查肾脏疾病严重程度、性腺功能减退、肌肉力量、甲状旁腺功能亢进症、并存条件和药物的影响。该方案将确定这一队列中性激素缺乏的特征,确定脊椎骨折的患病率和发生率,检查骨转换和破骨细胞生成调节的基线测量作为骨丢失的预测因子,并将检查常规DXA在Rod评估中的应用。准确描述CRI的骨结构对于识别脆性的危险因素和评估潜在的治疗方法是必要的。

项目成果

期刊论文数量(5)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
A structural approach to skeletal fragility in chronic kidney disease.
  • DOI:
    10.1016/j.semnephrol.2009.01.006
  • 发表时间:
    2009-03
  • 期刊:
  • 影响因子:
    3.3
  • 作者:
    Leonard, Mary B.
  • 通讯作者:
    Leonard, Mary B.
Associations between body composition and bone density and structure in men and women across the adult age spectrum.
  • DOI:
    10.1016/j.bone.2012.11.035
  • 发表时间:
    2013-03
  • 期刊:
  • 影响因子:
    4.1
  • 作者:
    Baker JF;Davis M;Alexander R;Zemel BS;Mostoufi-Moab S;Shults J;Sulik M;Schiferl DJ;Leonard MB
  • 通讯作者:
    Leonard MB
Insulin-like Growth Factor 1 and Adiponectin and Associations with Muscle Deficits, Disease Characteristics, and Treatments in Rheumatoid Arthritis.
  • DOI:
    10.3899/jrheum.150280
  • 发表时间:
    2015-11
  • 期刊:
  • 影响因子:
    0
  • 作者:
    Baker JF;Von Feldt JM;Mostoufi-Moab S;Kim W;Taratuta E;Leonard MB
  • 通讯作者:
    Leonard MB
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Mary Beth Leonard其他文献

Mary Beth Leonard的其他文献

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{{ truncateString('Mary Beth Leonard', 18)}}的其他基金

Bone Health in Pediatric Crohn Disease: A Low Magnitude Mechanical Stimulus Trial
儿童克罗恩病的骨骼健康:低强度机械刺激试验
  • 批准号:
    7898166
  • 财政年份:
    2009
  • 资助金额:
    $ 54.59万
  • 项目类别:
Patient Oriented Research in Vitamin D and Physical Functioning in CKD
以患者为导向的 CKD 维生素 D 和身体机能研究
  • 批准号:
    7340538
  • 财政年份:
    2007
  • 资助金额:
    $ 54.59万
  • 项目类别:
Patient Oriented Research in Vitamin D and Physical Functioning in CKD
以患者为中心的 CKD 维生素 D 和身体机能研究
  • 批准号:
    7186236
  • 财政年份:
    2007
  • 资助金额:
    $ 54.59万
  • 项目类别:
CHANGES IN SKELETAL MICROARCHITECTURE FOLLOWING RENAL TRANSPLANTATION
肾移植后骨骼微结构的变化
  • 批准号:
    7265447
  • 财政年份:
    2007
  • 资助金额:
    $ 54.59万
  • 项目类别:
Vitamin D Deficiency, Physical Performance and Cardiovascular Outcomes in CRIC
CRIC 中的维生素 D 缺乏、身体机能和心血管结局
  • 批准号:
    7316816
  • 财政年份:
    2007
  • 资助金额:
    $ 54.59万
  • 项目类别:
Patient Oriented Research in Vitamin D Deficiency in CKD
以患者为导向的 CKD 维生素 D 缺乏症研究
  • 批准号:
    8512709
  • 财政年份:
    2007
  • 资助金额:
    $ 54.59万
  • 项目类别:
CHANGES IN SKELETAL MICROARCHITECTURE FOLLOWING RENAL TRANSPLANTATION
肾移植后骨骼微结构的变化
  • 批准号:
    7674591
  • 财政年份:
    2007
  • 资助金额:
    $ 54.59万
  • 项目类别:
Patient Oriented Research in Vitamin D Deficiency in CKD
以患者为导向的 CKD 维生素 D 缺乏症研究
  • 批准号:
    8299243
  • 财政年份:
    2007
  • 资助金额:
    $ 54.59万
  • 项目类别:
4th International Conference on Children's Bone Health
第四届国际儿童骨骼健康会议
  • 批准号:
    7277973
  • 财政年份:
    2007
  • 资助金额:
    $ 54.59万
  • 项目类别:
CHANGES IN SKELETAL MICROARCHITECTURE FOLLOWING RENAL TRANSPLANTATION
肾移植后骨骼微结构的变化
  • 批准号:
    8144171
  • 财政年份:
    2007
  • 资助金额:
    $ 54.59万
  • 项目类别:

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