Long term fracture risk and change in peripheral bone in the oldest old men: The MrOS study

最年长男性的长期骨折风险和周围骨变化：MrOS 研究

• 批准号: 10264783
• 负责人: MARY L BOUXSEIN
• 金额: $ 118.01万
• 依托单位: CALIFORNIA PACIFIC MED CTR RES INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-30 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10264783
• 关键词: Address; Age; Aged, 80 and over; Aging; Bone Density; Bone structure; Cessation of life; Clinical; Cohort Studies; Collection; Communication; Data; Data Coordinating Center; Data Discovery; Dual-Energy X-Ray Absorptiometry; Elderly; Enrollment; Fracture; Funding; Future; Goals; Hip Fractures; Hip region structure; Infrastructure; Knowledge; Life; Measurement; Measures; Morbidity - disease rate; Musculoskeletal; Participant; Peripheral; Phase; Phenotype; Prospective Studies; Publications; Research Personnel; Resources; Risk Factors; Scanning; Source; Structure; Vertebral column; X-Ray Computed Tomography; base; bone; bone imaging; bone strength; clinical phenotype; clinical research site; cohort; cost; design; falls; follow-up; fracture risk; health assessment; human very old age (85+); improved; men; mortality; novel; older men; osteoporosis with pathological fracture; scientific organization; skeletal

ABSTRACT Fractures and resulting morbidity, mortality and costs are a large and growing burden among older men. The fracture rate increases exponentially after age 65, and the average age of hip fracture is >80 yrs. Fracture risk in later life is strongly influenced by long term declines in bone density, structure and strength, and during this period skeletal change accelerates. The Osteoporotic Fractures in Men Study (MrOS) is an ongoing, prospective study of risk factors for osteoporotic fractures in older men. The study continues to follows men who were initially enrolled in 2000-2. MrOS is best phenotyped cohort of the oldest men – now in the 9th and 10th decades of life – when fractures are a major threat to maintaining independence. More than 20 years ago, we began to obtain serial DXA measures and complete clinical phenotyping. At baseline, hip and spine CT scans (N=3695) were obtained to assess bone structure and strength. Similarly, HR-pQCT (XtremeCTII) scans were obtained in a large number of men (N=1831) in 2014-6. Thus, MrOS remains the unique source of data and discoveries about musculoskeletal aging in men, and is uniquely suited to address several key clinical and mechanistic knowledge gaps regarding skeletal fragility in older men. The study’s comprehensive bone imaging, its long follow-up and the very old age of the cohort provide unparalleled opportunities to generate novel information needed to design effective approaches to reduce the burden of fractures in older men. The overarching goal of this project is to provide continuity in the organization of the study, continue the infrastructure for the MrOS project, allow for continued follow-up of the participants, and support the collection of limited study measurements. The specific aims of this project are to support the ongoing MrOS infrastructure. These include to 1) continue follow-up for MrOS participants for fractures, falls, mobility limitation and death; 2) collect repeat HR-pQCT scans in a subset of active MrOS participants; and 3) maintain the scientific organization for study communications; publications and ancillary review; and the public data release infrastructure. These aims will provide the critical framework required to address future scientific goals, such as characterization of the circumstances of fractures in the oldest old; quantification of change in peripheral bone microarchitecture by HR-pQCT and identification of determinants of that change; and determination of the utility of hip and spine CT based CT-FEA measures to predict fracture risk in older men.

抽象的 骨折和导致的发病率，死亡率和成本在老年男性中越来越大。骨折率在65岁之后指数增长，髋部骨折的平均年龄> 80年。以后生命中的断裂风险受骨密度，结构和强度的长期下降，在此期间，骨骼变化加速。 男性研究（MROS）中的骨质疏松性骨折是对老年男性骨质疏松性骨折的危险因素的前瞻性研究。该研究继续跟随最初在2000-2入学的男性。 MRO是最古老的男人的最好的表型队列，现在是现在的第9和10年，当时骨折是维持独立性的主要威胁。 20多年前，我们开始获得串行DXA测量和完整的临床表型。 在基线时，获得了臀部和脊柱CT扫描（n = 3695），以评估骨骼结构和强度。同样，2014 - 6年获得了大量男性（n = 1831），获得了HR-PQCT（Xtremectii）扫描。这是MROS仍然是男性肌肉骨骼衰老的独特数据来源，并且非常适合解决老年男性骨骼脆弱性的几个关键临床和机械知识差距。该研究的综合骨成像，其长时间的随访和非常年龄的人群提供了无与伦比的机会，以生成设计有效方法来减少老年男性骨折燃烧所需的新型信息。 该项目的总体目标是提供研究组织的连续性，继续MROS项目的基础设施，允许继续对参与者进行后续措施，并支持收集有限的研究测量结果。 该项目的具体目的是支持正在进行的MROS基础设施。其中包括1）继续对MROS参与者进行裂缝，跌倒，流动性限制和死亡的随访； 2）在主动MROS参与者的一部分中收集重复HR-PQCT扫描； 3）维护研究沟通的科学组织；公众和辅助评论；以及公共数据发布基础架构。 这些目标将提供解决未来科学目标所需的关键框架，例如表征最古老的旧骨折情况；通过HR-PQCT量化外周骨微体系结构的变化，并确定该变化的确定；并确定基于髋关节和脊柱CT的CT-FEA措施的效用，以预测老年男性的破裂风险。