Biomechanical Stimulation & Skeletal Health in Adolescents with Anorexia Nervosa

生物力学刺激

• 批准号: 8010161
• 负责人: AMY D DIVASTA
• 金额: $ 13.13万
• 依托单位: BOSTON CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-01-05 至 2013-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8010161
• 关键词: Acute; Address; Admission activity; Adolescence; Adolescent; Alkaline Phosphatase; Amenorrhea; Anorexia Nervosa; Area; Award; Bed rest; Biochemical; Biochemical Markers; Biological Markers; Biomechanics; Bone Density; Bone Resorption; Bone remodeling; C-terminal; Cardiac; Caring; Childhood; Chronic Disease; Clinical; Clinical Research; Control Groups; Coupled; Data; Development; Development Plans; Disease; Elderly; Epidemic; Epidemiology; Equilibrium; Evidence based treatment; Exercise; Exhibits; Exposure to; Fluorides; Fracture; Frequencies; Fright; Future; Goals; Health; Healthcare; Hormonal; Hospitalization; Imaging Techniques; Immobilization; Insulin-Like Growth Factor I; Intervention; Knowledge; Lead; Leadership; Leptin; Long-Term Effects; Malnutrition; Measurement; Measures; Mechanical Stimulation; Mechanics; Medical; Mentors; Mentorship; Methods; Morbidity - disease rate; Osteoblasts; Osteocalcin; Osteogenesis; Osteoporosis; Participant; Pathway interactions; Patients; Peripheral; Physical activity; Physiology; Placebos; Population; Positron-Emission Tomography; Prevention; Prevention strategy; Randomized; Randomized Controlled Trials; Relative (related person); Research; Research Personnel; Research Project Grants; Risk; Secondary to; Serum; Signal Transduction; Site; Skeleton; Somatomedins; Statistical Methods; Techniques; Time; Training; Treatment Protocols; Vertebral column; Weight; Weight Gain; Weight-Bearing state; Woman; Work; X-Ray Computed Tomography; active method; adiponectin; arm; bone; bone geometry; bone health; bone loss; bone mass; bone strength; bone turnover; care burden; career; career development; design; effective intervention; evidence base; improved; indexing; innovation; mortality; novel; nutrition; prevent; prospective; skeletal; skills; stem; substantia spongiosa; tibia; treatment strategy

DESCRIPTION (provided by applicant): Anorexia nervosa is a chronic illness resulting in significant morbidity and mortality, including the compromised accrual of bone mass during adolescence. Effective prevention and treatment strategies remain unclear. The proposed study focuses on the short-term and long term effects of a novel, nonpharmacologic intervention on bone markers, and the prevention of deleterious changes in bone density and strength in adolescents with AN. The Candidate's long-range career goal is to find a safe, efficacious intervention to prevent the longterm negative effects of this chronic illness on future bone health. Coupled with this goal is a desire to increase understanding of the strategies to prevent bone loss in at-risk pediatric and adolescent patients, and to elucidate the pathways that lead to skeletal deficits in these populations. The proposed career development plan includes additional training and mentorship in 4 areas critical to the Candidate's development as an independent investigator: (1) bone physiology and biomechanics; (2) advanced training in epidemiology and the statistical methods needed to analyze these longitudinal data; (3) use of novel techniques for assessment of skeletal health; and (4) further development of leadership and mentoring skills. The research plan includes 3 aims: (1) To determine the short-term effects of low magnitude mechanical stimulation (LMMS) on bone turnover in adolescents who are hospitalized for AN; (2) To determine the longterm effects of LMMS on bone geometry and bone strength in ambulatory adolescents with a ; and (3) To determine the longterm effects of LMMS on biochemical indices of bone remodeling in ambulatory adolescents with AN. The proposed career development plan will provide the training and data necessary to support an R01 application during the later years of the award period. The results of these studies will have broad-reaching clinical importance, as evidence-based treatment protocols will likely stem from these data that result in improved care achieved for adolescents and young women with this common chronic disease. Given the health care burden associated with the current epidemic of osteoporosis in the elderly, establishing effective measures to prevent bone loss during childhood and adolescence is paramount.

描述（由申请人提供）：神经性厌食症是一种慢性疾病，发病率和死亡率高，包括青春期骨量累积受损。有效的预防和治疗策略尚不清楚。这项研究的重点是一种新的、非药物干预对骨标志物的短期和长期影响，以及预防青少年AN患者骨密度和强度的有害变化。候选人的长期职业目标是找到一种安全有效的干预措施，以防止这种慢性疾病对未来骨骼健康的长期负面影响。与此目标相结合的是希望增加对预防高危儿童和青少年患者骨质流失策略的理解，并阐明导致这些人群骨骼缺陷的途径。拟议的职业发展计划包括4个领域的额外培训和指导，这些领域对候选人作为独立研究者的发展至关重要：(1)骨骼生理学和生物力学；(2)流行病学方面的高级培训和分析这些纵向数据所需的统计方法；(3)使用新技术评估骨骼健康；(4)领导力和师徒技能的进一步发展。本研究计划包括三个目标：(1)确定低强度机械刺激（LMMS）对AN住院青少年骨转换的短期影响；(2)探讨LMMS对非卧床青少年a型骨质疏松症患者骨形态和骨强度的长期影响；(3)探讨LMMS对动态AN青少年骨重塑生化指标的长期影响。拟议的职业发展计划将提供必要的培训和数据，以便在奖励期的后期支持R01申请。这些研究的结果将具有广泛的临床重要性，因为基于证据的治疗方案可能源于这些数据，从而改善对患有这种常见慢性疾病的青少年和年轻妇女的护理。鉴于目前老年人骨质疏松症流行带来的医疗负担，制定有效措施预防儿童和青少年时期骨质流失至关重要。