IDEA

主意

• 批准号: 8167018
• 负责人: Stephen P Messier
• 金额: $ 33.52万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-03-01 至 2011-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8167018
• 关键词: Adult; Age; American; Arthritis; Biological Markers; Body Weight decreased; Clinical; Computer Retrieval of Information on Scientific Projects Database; Degenerative polyarthritis; Disease Pathway; Disease Progression; Dose; Exercise; Funding; Grant; Inflammation; Inflammatory; Institution; Intervention; Knee; Knee Osteoarthritis; Knee joint; Mediator of activation protein; Obesity; Outcome; Overweight; Pain; Participant; Patient Self-Report; Population; Population Study; Prevalence; Randomized; Research; Research Personnel; Resources; Risk; Source; Stimulus; Time; United States National Institutes of Health; dietary restriction; intervention effect; joint loading; quadriceps muscle; response

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. Osteoarthritis (OA) is the most common form of arthritis with a prevalence conservatively estimated at 21 million Americans, or 12.1% of the adult population. We recently showed that a 5% weight loss in obese adults with knee OA had a modest effect on clinical outcomes; however, these participants remained obese at the conclusion of the intervention, so their risk of disease progression was not altered. We hypothesize that a more intensive weight loss (2 to 3 times greater than previously achieved in this population) would provide the stimulus necessary to reduce inflammation and joint loads and alter disease progression. The study population will consist of 450 overweight and obese, older (age = 60 yrs) adults with tibiofemoral osteoarthritis of one or both knees. Participants will be randomized to 1 of 3, 18-month interventions: intensive dietary restriction-plus-exercise; exercise-only; or intensive dietary restriction-only. The primary aim is to compare the effects of these interventions on inflammatory biomarkers and knee joint loads in overweight and obese adults with knee OA. Secondary aims are: to compare the effects of these interventions on self-reported function and pain, and mobility; to determine the dose response to weight loss on disease progression and the mechanisms associated with the OA disease pathway; to determine if inflammatory biomarkers and knee joint loads are mediators of the interventions, with significant effects on function, pain, and disease progression and to determine the association between quadriceps strength and disease progression as a function of knee alignment.

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 骨关节炎（OA）是最常见的关节炎形式，保守估计有2100万美国人患病，占成年人口的12.1%。我们最近发现，患有膝关节OA的肥胖成年人体重减轻5%对临床结局的影响不大;然而，这些参与者在干预结束时仍然肥胖，因此他们的疾病进展风险没有改变。我们假设，更密集的体重减轻（比以前在这一人群中达到的体重减轻2至3倍）将提供必要的刺激，以减少炎症和关节负荷，并改变疾病进展。 研究人群将包括450例超重和肥胖、单侧或双侧膝关节胫股骨关节炎的老年（年龄= 60岁）成人。参与者将被随机分配到3个为期18个月的干预措施中的1个：强化饮食限制加运动;仅运动;或仅强化饮食限制。主要目的是比较这些干预措施对超重和肥胖成人膝关节OA炎症生物标志物和膝关节负荷的影响。次要目标是：比较这些干预措施对自我报告的功能和疼痛以及活动性的影响;确定体重减轻对疾病进展的剂量反应以及与OA疾病途径相关的机制;确定炎症生物标志物和膝关节负荷是否是干预的介质，对功能，疼痛，和疾病进展之间的关系，并确定股四头肌力量和疾病进展之间的关联作为膝关节对准的函数。