The Johnston County OA Project: Arthritis and Disability

描述（由申请人提供）：摘要根据RFA-DP 11 -005，本研究将提供45岁及以上非裔美国人和白人中放射学膝关节和髋关节OA、膝关节和髋关节症状以及残疾的患病率、发生率和进展的长期结局数据。它还将检查伴随肥胖、糖尿病和心血管疾病的发生和时间，以及它们对OA结局的相互作用，并延长检查风险（腿长不等）和潜在保护因素（体重维持）的时间轴。本提案要求提供流程和技术支持，以完成约翰斯顿县骨关节炎项目的第3次随访（T3），第2次5年随访（T2）后平均4 - 7年，第1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其作用。这项研究的后续时间很长，有望填补这一知识空白。这项研究的风险因素的发病率和进展，这些结果的AA和白人在农村，南部县，包括广泛的放射学，临床，访谈和功能数据超过4,300人（约1/3非洲裔美国人，40%的男性）在过去的20年。符合T3条件的当前样本包括来自原始T0基线时间点的个体以及来自2003-2004年进行的2个队列富集和2011- 2012年正在进行的2个队列富集的个体。T3的协议和数据收集工具目前正在开发中，如果成功，将在这笔赠款获得资助时获得批准。所有人将完成膝关节、髋关节、髌股关节、手和腰椎的放射学检查、身体和功能检查、广泛的访谈和DEXA，并捐献尿液和血液用于储存血清、血浆、DNA和RNA。分层分析和多重logistic和多分类logistic回归以及至事件发生时间分析（适当时使用广义估计方程）将用于评估T0、T1和T2时评估的风险因素的作用及其时间在T3时上述结局的发生率和进展中的种族差异。因此，拟议的研究将客观地定义这些组中膝关节和髋关节OA随时间推移的负担，增加有关这些关节OA发生率和进展相关因素的知识，识别这些结局的潜在可改变风险因素，并识别高风险亚组。通过在一项研究中检查两个种族OA过程多个方面的这些因素，可以最大限度地提高效率和对公众健康的重大影响。

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.