Evaluating the Association between Cardiometabolic Health Over the Lifespan and Vertebral Strength

评估终生心脏代谢健康与椎骨强度之间的关联

• 批准号: 10586010
• 负责人: Nicole C Wright
• 金额: $ 68.01万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-03-01 至 2028-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10586010
• 关键词: Adult; Attenuated; Biological; Biological Markers; Biomechanics; Black race; Bone Density; Bone Resorption; Cardiometabolic Disease; Central obesity; Classification; Clinical; Clinical Data; Coronary Artery Risk Development in Young Adults Study; Data; Dependence; Dual-Energy X-Ray Absorptiometry; Elderly; Eligibility Determination; Equation; Evaluation; Female; Fracture; Goals; Health; Hyperlipidemia; Hypertension; Image; Individual; Inflammation; Intervention; Investigation; Life Cycle Stages; Lipids; Longevity; Measurement; Measures; Mediating; Medicaid; Modeling; Molecular; Non-Insulin-Dependent Diabetes Mellitus; Osteoclasts; Osteogenesis; Participant; Pattern; Predictive Factor; Public Health; Questionnaires; Race; Renal function; Research Design; Research Personnel; Role; Scanning; Spinal Fractures; Technology; Time; United States; Vertebral Bone; X-Ray Computed Tomography; abdominal CT; aged; biomarker identification; blood glucose regulation; bone health; bone mass; bone strength; burden of illness; cardiometabolism; cardiovascular health; cohort; epidemiology study; fracture risk; fragility fracture; glucose metabolism; health assessment; health data; high risk population; male; men; mortality risk; novel; nursing home length of stay; sex; spine bone structure; women of color

ABSTRACT Fragility fractures are a substantial public health problem in older adults in the United States (US), with vertebral fractures being the most prevalent fracture type. Cardiometabolic disorders (e.g., hypertension, type 2 diabetes mellitus, abdominal obesity, and hyperlipidemia) have been associated with lower bone strength, bone mineral density (BMD), and higher fracture risk. Although several epidemiologic studies have evaluated the role of cardiometabolic health on vertebral fractures, by not accounting for the clustering of cardiometabolic conditions, many of the study findings are limited. Large studies with the ability to adjust for multiple cardiometabolic conditions are needed to provide information on the full effect of cardiometabolic conditions on vertebral health, including BMD and strength. Studies evaluating molecular mechanisms of cardiometabolic conditions on vertebral health also have study design limitations, including the lack of adjustment for clustering of other cardiometabolic conditions and/or biomarkers, and cross-sectional evaluations where either the cardiometabolic exposures and/or bone health data are assessed at a single time point. The lack of longitudinal data limits our ability to understand how cardiometabolic health is related to vertebral health. Lastly, advances in computed tomography (CT) technology has allowed for bone mass and strength measurements. Biomechanical CT (BCT) analysis has allowed researchers to obtain validated bone mass and strength on CT images obtained for other clinical indications, opening the investigation of the role of cardiometabolic disorders on vertebral health in individuals who do not routinely receive DXA imaging (i.e. women of color and men). The Coronary Artery Risk Development in Young Adults (CARDIA) study has followed 5,115 Black and White male and female adults aged 18-30 years at baseline for 35 years. The proposed study will build on CARDIA’s previously collected cardiometabolic disease and biomarker data. It will also add vertebral strength data through BCT analysis of Year 25 and 35 abdominal CT scans. Our aims are to: 1) Evaluate the association between cardiometabolic disease patterns and vertebral health, 2) Determine the role of cardiometabolic biomarkers on vertebral health, and 3) Identify cardiometabolic health factors that predict 10-year changes in vertebral health. Our overall goal is to provide unbiased and longitudinal estimates of the association between cardiometabolic health and vertebral health, and to explore the potential biologic mechanisms of these associations. Determining how cardiometabolic disease patterns and biomarkers, at clinical or subclinical levels, impact vertebral bone health is highly desirable and can lead to changes in fracture screening protocols in this high risk population.

摘要 脆性骨折是美国（US）老年人的一个重大公共卫生问题， 骨折是最常见的骨折类型。心脏代谢疾病（例如，2型高血压 糖尿病、腹部肥胖和高脂血症）与骨强度、骨密度和骨密度降低有关。 矿物质密度（BMD），骨折风险更高。尽管一些流行病学研究已经评估了 心脏代谢健康对椎骨骨折的影响， 在这种情况下，许多研究结果是有限的。能够针对多个因素进行调整的大型研究 需要心脏代谢状况来提供关于心脏代谢状况对 脊椎健康，包括BMD和力量。评价心脏代谢的分子机制的研究 脊椎健康状况也有研究设计的局限性，包括缺乏对聚类的调整。 其他心脏代谢疾病和/或生物标志物，以及横断面评价，其中 在单个时间点评估心脏代谢暴露和/或骨骼健康数据。缺乏纵向 数据限制了我们理解心脏代谢健康如何与脊椎健康相关的能力。最后，进步 在计算机断层扫描（CT）技术中，允许进行骨质量和强度测量。 生物力学CT（BCT）分析使研究人员能够在CT上获得经验证的骨量和强度 为其他临床适应症获得的图像，开启了对心脏代谢疾病作用的研究 不定期接受DXA成像的个体（即有色人种女性和男性）的脊椎健康。的 年轻人冠状动脉风险发展（CARDIA）研究跟踪了5,115名黑人和白色男性 和基线时年龄为18-30岁的女性成年人，持续35年。拟议的研究将建立在CARDIA的 先前收集的心脏代谢疾病和生物标志物数据。它还将通过以下方式添加椎骨强度数据： 25岁和35岁腹部CT扫描的BCT分析。我们的目标是：1）评估之间的关联 心脏代谢疾病模式和脊椎健康，2）确定心脏代谢疾病的作用， 脊椎健康的生物标志物，和3）确定心脏代谢健康因素，预测10年 脊椎健康的变化。我们的总体目标是提供无偏的纵向估计， 心脏代谢健康和脊椎健康之间的联系，并探索潜在的生物学 这些协会的机制。确定心脏代谢疾病模式和生物标志物， 临床或亚临床水平，影响椎体骨健康是非常可取的，并可能导致骨折的变化 在这个高危人群中进行筛查。