Sex Differences in Musculoskeletal Conditions across the Lifespan

描述（由申请人提供）：肌肉骨骼疾病是美国初级保健医生就诊最常见的疾病，随着年龄的增长，女性肌肉骨骼疾病（特别是骨质疏松症和骨关节炎）的发病率增加高于男性，并导致大量残疾和生活质量下降。流行病学数据清楚地表明，随着年龄的增长，女性患肌肉骨骼疾病的比例高于男性，但这种性别差异的生物学解释仍不清楚。这项跨学科、多机构的提案题为“一生中肌肉骨骼状况的性别差异”，其目的是整合关于获得峰值骨量的生理学性别差异的前沿基础科学，关于骨形状性别差异与骨关节炎发生、严重程度和预后关系的流行病学研究，高分辨率超声在腕管综合征保守治疗和手术治疗的诊断和预后中的性别差异的临床研究，以及对脊柱后凸进行体力活动干预的性别差异的随机试验。该专门研究中心的总体目标是为诊断和治疗男女肌肉骨骼疾病的预防工作和临床实践提供信息和进行改革，从而改善妇女的健康。组成该中心的四个项目将进行关键的创新研究，以通过以下方式来表征肌肉骨骼状况的性别差异：1）与调节或影响峰值骨量相关的孕酮受体性别差异的机制研究，（二）一项使用新型诊断技术的前瞻性临床队列研究，以检查该技术诊断腕管综合征和性别结果的性别差异标准治疗方法的差异，3）一项流行病学影像学研究，评估骨形状的性别差异以及骨形状对膝关节骨关节炎的发展、严重程度和预后的影响，4）一项随机临床试验，研究运动干预治疗后凸的性别差异。该中心的研究成果将通过中心研究人员在一些不同的论坛上的演讲，包括加州大学戴维斯分校和加州大学旧金山分校的继续医学教育计划，以及当地的大型圆桌会议和全国会议，翻译到当地和国家医学界。 公共卫生参考：这个翻译SCOR补助金，“跨寿命的肌肉骨骼疾病的性别差异”，重点关注四种不同性别的肌肉骨骼疾病或综合征，包括峰值骨量（基于实验室的项目），腕管综合征（流行病学和观察），膝关节骨关节炎（观察）和脊柱后凸（运动干预）。每个项目将仔细确定与肌肉骨骼疾病有关的性别差异，并为预防和临床实践提供信息。

DESCRIPTION (provided by applicant): Musculoskeletal Diseases comprise the most frequent ailment for primary care physician visits in the United States, and the increases in incidence of musculoskeletal diseases with aging (particularly osteoporosis and osteoarthritis) is higher in women than in men, and leads to a significant amount of disability and reduced quality of life. Epidemiologic data clearly demonstrate the proportion of women affected my musculoskeletal diseases is higher than in men with aging, yet the biologic explanation for this sex difference remains unclear. The objective of this interdisciplinary, multi-institutional proposal, entitled "Sex Differences in Musculoskeletal Conditions Across the Lifespan," is to integrate cutting-edge basic science regarding sex differences in the physiology relate to acquiring peak bone mass, epidemiologic study on the relation of sex differences in bone shape to occurrence, severity and prognosis of osteoarthritis, clinical study of sex differences in high resolution ultrasound in diagnosis and prognosis of carpal tunnel syndrome with conservative and surgical treatment, and a randomized trial of sex differences in response to a physical activity intervention for kyphosis. The overarching goal of this Specialized Center of Research is to inform and transform preventive efforts and clinical practice in diagnosis and treatment of these musculoskeletal conditions in both sexes and lead to improvements in women's health. The four projects that compose the Center will conduct critical, innovative research to characterize sex differences in musculoskeletal conditions via: 1) a mechanistic study of sex differences in progesterone receptors that are related to regulation or influence peak bone mass, 2) a prospective clinical cohort study using novel diagnostic technology to examine sex differences in the results of this technology to diagnose carpal tunnel syndrome and sex differences in standard treatments for this condition, 3) an epidemiologic imaging study to assess sex differences in bone shape and the influence of bone shape on the development, severity and prognosis of osteoarthritis of the knee, and 4) a randomized clinical trial of sex differences in response to an exercise intervention for the treatment of kyphosis. The Center's research results will be translated to the local and national medical community's through presentations by Center researchers at a number of different forums, including UC Davis and UCSF continuing medical education programs, as well as local grand rounds and national meetings. PUBLIC HEALTH REFERENCE: This translational SCOR grant, "Sex Differences in Musculoskeletal Diseases Across the Lifespan," focuses on four musculoskeletal diseases or syndromes that differ by sex and include peak bone mass (a laboratory based project), carpal tunnel syndrome (epidemiologic and observational), osteoarthritis of the knee (observational), and kyphosis (exercise intervention). Each project will carefully determine the sex differences in relation to the musculoskeletal diseases and inform preventive and clinical practices.