Sex differences in bone shape and knee osteoarthritis: the Osteoarthritis Initia

骨骼形状和膝骨关节炎的性别差异：骨关节炎初始阶段

• 批准号: 8734223
• 负责人: Nancy E Lane
• 金额: $ 2.47万
• 依托单位: UNIVERSITY OF CALIFORNIA AT DAVIS
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-01 至 2017-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8734223
• 关键词: Age; Body mass index; Cartilage; Characteristics; Clinical Trials; Data Collection; Degenerative polyarthritis; Deterioration; Distal; Early Intervention; Elderly woman; Estrogens; Event; Femur; Goals; Hip Osteoarthritis; Image; Imaging Techniques; Incidence; Instruction; Joints; Knee; Knee Osteoarthritis; Knee bone; Lesion; Logistic Regressions; Longevity; Magnetic Resonance Imaging; Measures; Methods; Modeling; Musculoskeletal; Pain; Pattern; Physical activity; Predictive Value; Prevalence; Preventive Intervention; Reporting; Research Design; Research Personnel; Risk; Risk Factors; Safe Sex; Severities; Sex Characteristics; Shapes; Symptoms; Therapeutic Intervention; Time; Woman; Work; base; bone; cohort; follow-up; high risk; improved; innovation; insight; men; novel; prevent; sex; tibia; tool

Incidence and prevalence of either radiographic or symptomatic osteoarthritis (OA) are much higher in women than men; however, the underlying causes for this sex difference in OA remain unknown. Several potential explanations have been proposed for the sex difference in OA, including differences in estrogen level, physical activity, and laxity or alignment, but each has only moderate supporting evidence, and none fully explains the observed sex differences. Recently, several investigators have proposed that aspects of bone shape are associated with an increased risk of incident OA and with severity of OA, based on anthropometric measures, cross-sectional findings, or in one case statistical shape modeling done on 24 knees. Our group demonstrated that several specific proximal femoral shapes, assessed by Active Shape Modeling (ASM), were associated with incident radiographic hip OA in elderly women. Others have also reported that ASM-based knee shape is associated with severity of radiographic knee OA. It is postulated that changes in bone shape occur prior to cartilage damage in the joint. In the proposed study, we will take the advantage of knee radiographs and magnetic resonance images (MRIs) collected annually for 5 years in the Osteoarthritis Initiative (OAI). We will measure femoral and tibial bone shape using an ASM method improved by our group. We will evaluate whether baseline bone shape is associated with incidence or progression of radiographic knee OA, pain and function and whether these associations differ by sex. We will apply group-based finite modeling methods to identify distinctive sub-groups that follow similar trajectories of bone shape change over time in women and men respectively and examine whether associations between various risk factors assessed at baseline (i.e., age, sex, body mass index, alignment, etc.) and membership of trajectories of bone shape differ by sex using a multinomial logistic regression model. Finally, we will evaluate the risk factors that determine sex-specific trajectories of bone shape change over time.

放射学或症状性骨关节炎（OA）的发病率和患病率在以下人群中要高得多： 女性多于男性;然而，OA性别差异的根本原因尚不清楚。几 已经提出了OA性别差异的可能解释，包括雌激素的差异 水平，体力活动，松弛或对齐，但每一个只有中等的支持证据，没有 充分解释了观察到的性别差异。最近，一些研究人员提出， 骨形状与OA发病风险增加和OA严重程度相关，基于 人体测量，横断面调查结果，或在一个案例中，统计形状建模完成24 膝盖我们的研究小组证明了几种特定的股骨近端形状，通过主动形状评估， 在老年女性中，建模（ASM）与影像学髋关节OA事件相关。其他人也 报告称，基于ASM的膝关节形状与影像学膝关节OA的严重程度相关。据推测 骨骼形状的变化发生在关节软骨损伤之前。在这项研究中，我们将 每年收集的膝关节X线片和磁共振图像（MRI）的优势为5年， Osteoarthritis Initiative（OAI）。我们将使用ASM方法测量股骨和胫骨形状 由我们的团队改进。我们将评估基线骨形状是否与发病率相关， 影像学膝关节OA的进展、疼痛和功能以及这些相关性是否因性别而异。我们将 应用基于组的有限建模方法来识别遵循相似轨迹的不同子组， 女性和男性的骨骼形状分别随时间变化， 在基线评估的各种风险因素（即，年龄、性别、体重指数、排列等）和会员 使用多项逻辑回归模型，骨形状的轨迹因性别而异。最后我们将 评估决定骨形状随时间变化的性别特异性轨迹的风险因素。