Multicenter Osteoarthritis Study (MOST) Renewal

骨关节炎（OA）是关节炎的最常见形式，并且膝关节或髋关节中的疾病是OA的主要原因。 残疾。大多数膝关节和髋关节OA的流行病学研究都集中在影像学疾病上，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， 巨大的社会和公共卫生影响。OA有可能是可以预防的，但只有少数人， 不可改变的风险因素已经确定，即使可改变的风险因素，如特定的活动， 已经提出了肌肉无力、本体感受缺陷、微量营养素缺乏和结构因素， 可能会对患病风险产生重大影响。预防机会最相关，最有可能被利用 被那些已经患病或有最高患病风险的人感染。 该建议将四种新方法引入膝关节骨关节炎的流行病学研究：l.重点关注 症状性疾病，2。对危险因素进行综合评价，包括可改变的危险因素，3.专注于那些 那些真正受益于预防机会的人，那些已经患病的人或那些处于高风险的人 得到它和4。结合了比以前使用的更全面和可再现的成像 包括最先进的射线照相技术和MRI。MRI提供了丰富的信息，结构因素， 哪些异常可能影响患病风险。 本研究的总体目标是纵向评估三组因素的影响： 生物力学因素（蹲、跪、爬楼梯、穿高跟鞋、股四头肌无力和 本体感受缺陷）、骨和结构因素（骨密度、骨髓和MRI上的骨损伤），以及 微量营养素缺乏症（维生素C、E和D）对症状和放射学检查的发生和进展的影响 膝关节骨性关节炎在50 - 79岁男性和女性人群中的样本。虽然这个项目的重点是膝盖 OA，我们还纳入了髋关节OA的研究。 我们建议招募3,000名可能患有膝关节OA或 OA的高风险。高风险人群包括那些超重的人，那些有膝盖症状的人和那些有 膝关节损伤或手术史。受试者将通过症状问卷、X光片和 MRI，并将随访36个月，以了解症状性或影像学OA的发展或进展。 分析将集中在这些重要的风险因素和OA结果的关系。 这项大型的、多方面的研究提供了明确的解决潜在的重要风险因素与 主要致残性疾病的发展或进展，并提供对疾病生物学的新见解， 预防疾病的潜在机会。

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.