The Johnston County OA Project: Arthritis and Disability

根据RFA-DP11-005，本研究将提供45岁及以上非裔美国人和白人的膝关节和髋关节骨关节炎、膝关节和髋关节症状和残疾的患病率、发病率和进展的长期结局数据。该研究还将研究伴随性肥胖、糖尿病和心血管疾病的发生和时间，以及它们对OA结果的相互作用，并延长对这些结果的风险（腿长不平等）和潜在保护因素（体重维持）的检查时间。本提案要求流程和技术支持，以完成约翰斯顿县骨关节炎项目的第三次随访（T3），第二次5年随访（T2）后平均4 - 7年，第一次随访后约10 - 15年，基线检查后20-25年（T0）。一些风险因素的影响可能需要比大多数OA研究中通常观察到的更长的时间才能发挥作用。这项长期随访的研究有望填补这一知识空白。在过去的20年里，对南部农村地区的黑人和白人中这些结果的发生和进展的危险因素进行了研究，包括对4300多人（大约1/3的非洲裔美国人，40%的男性）的广泛的放射学、临床、访谈和功能数据。目前符合T3条件的样本包括来自原始T0基线时间点的个体，以及来自2003-2004年和2011-12年进行的2个队列充实的个体。T3的方案和数据收集工具目前正在开发中，如果成功，将在本赠款获得资助时可用并获得批准。所有患者均需完成膝关节、髋部、髌股关节、手部和腰椎的x线检查、体格和功能检查、广泛访谈和DEXA，并提供尿液和血液用于血清、血浆、DNA和RNA的储存。分层分析、多元逻辑回归和多元逻辑回归，以及时间-事件分析，适当时使用广义估计方程，将用于评估T0、T1和T2评估的危险因素及其时间在T3时上述结果的发生率和进展中的作用的种族差异。因此，拟议的研究将客观地定义这些组中膝关节和髋关节骨性关节炎的负担，增加对这些关节骨性关节炎发病率和进展相关因素的了解，确定这些结果的潜在可改变的危险因素，并确定高风险亚组。通过在一项研究中检查两个族裔OA过程的多个方面的这些因素，可以最大限度地提高效率并对公共卫生产生重大影响。

DESCRIPTION (provided by applicant): Abstract In accordance with RFA-DP11-005, this study will provide long-term outcome data for the prevalence, incidence and progression of radiographic knee and hip OA, knee and hip symptoms, and disability in African Americans and Whites, aged 45 years and older. It will additionally examine the occurrence and timing of concomitant obesity, diabetes mellitus, and cardiovascular disease, and their interactive effects, upon OA outcomes, and extend the timeline for examination of risk (leg length inequality) and potentially protective factors (weight maintenance) upon these outcomes. This proposal requests process and technical support to complete the 3rd follow-up (T3) of the Johnston County Osteoarthritis Project, an average of 4 - 7 years after the 2nd 5-year follow-up (T2), approximately 10 - 15 years after the 1st follow-up, and 20-25 years after the baseline examination (T0). The effect of some risk factors may take longer time periods to exert their effects than are commonly observed in most OA studies. This study with its long follow-up time is poised to fill that knowledge gap. This study of risk factors for incidence and progression of these outcomes in AAs and Whites in a rural, Southern county has included extensive radiographic, clinical, interview, and functional data on over 4,300 individuals (approximately 1/3 African American, 40% men) throughout these past 20 years. The current sample eligible for T3 includes individuals from the original T0 baseline time point as well as individuals from 2 cohort enrichments conducted in 2003-2004 and ongoing in 2011-12. The protocol and data collection instruments for T3 are now in development, and will be available and approved by the time this grant, if successful, is funded. All individuals will complete radiographic examinations of the knees, hips, patellofemoral joints, hands, and lumbar spine, physical and functional examination, extensive interviews, and DEXA, and contribute urine and blood for storage of serum, plasma, DNA and RNA. Stratified analysis and multiple logistic and polytomous logistic regression, and time-to-event analyses, with generalized estimating equations when appropriate, will be used to assess ethnic differences in the roles of risk factors assessed at T0, T1, and T2, and their timing, in the incidence and progression of the above outcomes at T3. The proposed study will thus define objectively the burden of knee and hip OA in these groups over time, increase knowledge about factors associated with the incidence and progression of OA of these joints, identify potentially modifiable risk factors for these outcomes, and identify high risk subgroups. By examining these factors in multiple aspects of the OA process in both ethnic groups within one study, efficiency and significant impact upon the public health can be maximized.