EPIDEMIOLOGY OF OSTEOPOROSIS IN WOMEN WITH LUPUS - MAMDC PROJECT

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 这项研究的具体目标是：1)估计240名狼疮患者和200名按年龄、种族和绝经状况匹配的可比对照组女性髋部和腰椎骨密度(BMD)的差异；2)在控制了传统的低BMD危险因素后，确定狼疮危险因素与低BMD的相关性；3)对参加这项横断面研究的受试者进行为期两年的跟踪调查，以评估狼疮女性与年龄、种族和绝经状况相匹配的可比对照组之间髋部和腰椎骨丢失率的差异；以及4)在控制了低骨密度的传统风险因素后，确定狼疮风险因素与狼疮女性骨丢失率增加的相关性。 这项研究将检验的假设是：1a)狼疮妇女髋部和脊柱的BMD低于匹配的对照组；1b)狼疮对髋部和脊椎骨密度的负面影响在高加索人中比非裔美国妇女更大；2a)导致低BMD的传统危险因素(多方和更年期状态、月经周期不规律或更年期提前、避免口服避孕药和/或激素替代治疗、体力活动水平降低和维生素D水平降低)与狼疮妇女髋部或腰椎的BMD降低有关；2b)在控制了低骨密度的传统危险因素后，狼疮的危险因素(疾病活动性更强，疾病更严重，皮质类固醇负荷更高，使用抗惊厥药物，以及存在肾脏疾病)与狼疮妇女髋部或腰椎的骨密度较低相关；3a)与跟踪两年的匹配对照组相比，狼疮妇女在额外两年的狼疮疾病期间髋部和脊柱处的骨丢失加速；3b)在高加索人中，狼疮对髋部和脊柱处骨丢失率的影响比非裔美国妇女更大；4a)传统的骨质疏松症危险因素(上文2a所述)与狼疮妇女加速骨质流失有关；以及4b)狼疮危险因素(上文2b所述)在控制了低骨密度的传统危险因素后，与狼疮妇女髋部或腰椎的加速骨质流失有关。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The specific aims to be addressed in this study are: 1) To estimate the differences in bone mineral density (BMD) at the hip and lumbar spine between 240 women with lupus and a comparable control group of 200 women matched by age, race, and menopause status; 2) To determine the association of lupus risk factors with low BMD in women with lupus, after controlling for traditional risk factors for low BMD; 3) To follow the subjects entered in the cross-sectional study over a two year period in order to estimate the difference in the rate of bone loss at the hip and lumbar spine between women with lupus and a comparable control group matched by age, race, and menopause status; and 4) To determine the association of lupus risk factors with increased rates of bone loss in women with lupus, after controlling for traditional risk factors for low BMD. The hypotheses to be examined in this study are: 1a) women with lupus have lower BMD at the hip and spine than matched controls; 1b) the negative effect of lupus on bone mineral density at the hip and spine is greater in Caucasian than in African-American women; 2a) traditional risk factors for low BMD (multiparty and menopause status, irregular menstrual cycles or premature menopause, avoidance of oral contraceptives and/or hormone replacement therapy, lower physical activity level, and decreased vitamin D levels) are associated with lower BMD at the hip or lumbar spine in women with lupus; 2b) lupus risk factors (greater disease activity, greater disease severity, higher corticosteroid burden, use of anticonvulsant drugs, and the presence of renal disease) are associated with lower BMD at the hip or lumbar spine in women with lupus, after controlling for traditional risk factors for low BMD; 3a) women with lupus have accelerated bone loss at the hip and spine during two additional years of lupus disease compared with matched controls followed for two years; 3b) the effect of lupus on the rate of bone loss at the hip and spine is greater in Caucasian than in African-American women; 4a) traditional osteoporosis risk factors (mentioned in 2a above) are associated with accelerated bone loss in women with lupus; and 4b) lupus risk factors (mentioned in 2b above) are associated with accelerated bone loss at the hip or lumbar spine in women with lupus, after controlling for traditional risk factors for low BMD.