The Johnston County OA Project: Arthritis and Disability

描述(申请人提供)：根据RFA-DP11-005，这项研究将提供45岁及以上非裔美国人和白人的患病率、发生率和进展、膝关节和髋关节症状以及残疾的长期结果数据。它还将检查伴随的肥胖、糖尿病和心血管疾病的发生和时间，以及它们对骨关节炎结果的交互影响，并延长对这些结果的风险(腿长不等)和潜在保护性因素(体重维持)进行检查的时间线。该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)，平均为第二次5年随访(T2)后的4-7年，第一次随访后的大约10-15年，以及基线检查(T0)后的20-25年。一些危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来发挥其影响。这项追踪时间较长的研究有望填补这一知识空白。这项关于南部农村县AAS和白人中这些后果发生和进展的风险因素的研究包括了过去20年中超过4300人(约1/3的非裔美国人，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条件的样本包括最初T0基线时间点的个人以及2003-2004年和2011-12年正在进行的2个队列浓缩的个人。目前正在开发用于T3的议定书和数据收集工具，如果成功，将在这笔赠款获得资金时提供和批准这些工具。所有个人将完成膝盖、髋关节、髌股关节、手和腰椎的X光检查、身体和功能检查、广泛的面谈和DEXA，并贡献尿液和血液以储存血清、血浆、DNA和RNA。将使用分层分析、多元Logistic回归和多分类Logistic回归，以及事件发生时间分析，并在适当的情况下使用通用估计方程来评估在T0、T1和T2评估的风险因素的作用及其时间在T3的上述结果的发生和进展中的种族差异。因此，拟议的研究将随着时间的推移客观地确定这些人群中膝关节和髋关节骨关节炎的负担，增加对与这些关节骨关节炎的发生和进展相关的因素的了解，确定这些结果的潜在可改变的危险因素，并确定高危亚组。通过在一项研究中对两个民族的开放式获取过程的多个方面的这些因素进行检查，可以最大限度地提高效率和对公共卫生的重大影响。

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.