Modifiable Risk Factors for Incident and Progressive Early Knee Osteoarthritis

发生和进行性早期膝骨关节炎的可改变危险因素

• 批准号: 9038993
• 负责人: Grace Lo
• 金额: $ 14.65万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-01 至 2018-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9038993
• 关键词: Age; Ancillary Study; Arterial Fatty Streak; Award; Behavior; Behavioral; Body mass index; Characteristics; Clinical; Clinical Research; Data; Degenerative polyarthritis; Development; Diabetes Mellitus; Disease; Disease Progression; Early Diagnosis; Enrollment; Exercise; Fasting; Fibrinogen; Funding; Goals; Grant; Health; Hospitals; Hyperlipidemia; Hypertension; Image; Incidence; Intervention; Intervention Studies; Knee; Knee Osteoarthritis; Knowledge; Lead; Letters; Light Exercise; Maryland; Measures; Mediating; Mediator of activation protein; Mentors; Metabolic syndrome; Minority; Moderate Exercise; Myocardial Infarction; Natural History; Obesity; Observational Study; Ohio; Pain; Parents; Participant; Patients; Perception; Persons; Pharmacologic Substance; Phase; Physical activity; Physical assessment; Population; Positioning Attribute; Principal Investigator; Public Health; Publishing; Questionnaires; Race; Recording of previous events; Recruitment Activity; Research; Research Personnel; Resources; Rhode Island; Risk; Risk Factors; Roentgen Rays; Sampling; Science; Secure; Self Efficacy; Serum; Social support; Statistical Methods; Strenuous Exercise; Structure; Survey Methodology; Surveys; Target Populations; Testing; Time; Tobacco use; Training; Trauma; United States National Institutes of Health; Universities; Visit; Woman; base; cardiovascular risk factor; career; clinical research site; cohort; coping; design; disease natural history; effective intervention; follow-up; high risk; interest; men; modifiable risk; novel; prevent; programs; psychosocial; repository; rheumatologist; skills

DESCRIPTION (provided by applicant): From a convenience perspective, many knee osteoarthritis (OA) studies have focused on those with moderate to severe disease because the natural history of OA occurs over years. Studying the disease earlier on is more challenging but this may be the timeframe in which an effective intervention can be implemented. Therefore, our interest is in those without disease or with early knee OA. When structures required to accommodate loading are compromised, knee OA occurs. Three domains of potentially modifiable risk factors that may contribute to the health of these load distributing structures include: physical activity, cardiovascular risk factors, and psychosocial characteristics and behaviors. Specific aims of this proposal are: Aim 1: To evaluate the influence of physical activity, defined by level of exercise, on incident and progressive early knee OA, expecting greater participation in light and moderate exercise to be protective; while greater participation in strenuous exercise will be deleterious. Aim 2: To investigate the influence of cardiovascular risk factors on knee OA anticipating that it may be an atheromatous disease. Aim 3: To examine the impact of psychosocial risk factors (e.g. pain coping strategies, self-efficacy, and social support) on knee OA. The Osteoarthritis Initiative (OAI) is an ideal setting in which to perform this proposed study, a publicly available observational study where 3284 were enrolled into the Incidence Cohort, a group selected to be at high risk for symptomatic knee OA. Participants attended 5 annual visits for comprehensive questionnaires, physical assessments, and standardized knee X-rays. Currently in the continuation phase, participants continue to have in-person encounters every 2 years allowing the opportunity to request additional survey information not included as part of the parent study. As a co-investigator of an ongoing ancillary study to the OAI and a researcher who has published 2 studies as lead author using OAI data, I am familiar with the design and conduct of the parent study to this proposed ancillary study. Therefore, I am optimally positioned to execute this proposed study that will potentially identify novel modifiable risk factors while contributing new data to enrich this already outstanding publicly available resource. I am a rheumatologist with a firm career goal to establish myself as an independent academic investigator with expertise in clinical OA research. By expanding my research interest from studying imaging-based determinants in knee OA to a broader approach including other clinical and patient-based factors, I will be able to study this disease comprehensively and more likely to identify risk factors that are indeed modifiable. To facilitate this goal, I plan to obtain formal training in survey methods, behavioral interventions, and research design, analysis and statistical methods related to behavior science research. This award will allow me to further expand my knowledge and skills, so that I will be able to establish a scientifically robust clinical research program and secure independent funding to sustain my research and mentor others.

描述（由申请人提供）：从方便的角度来看，许多膝关节骨关节炎（OA）研究都集中在中度至重度疾病患者身上，因为OA的自然病程持续多年。早期研究这种疾病更具挑战性，但这可能是可以实施有效干预的时间框架。因此，我们的兴趣是那些没有疾病或早期膝关节OA。当需要适应载荷的结构受损时，发生膝关节OA。可能有助于这些负荷分布结构的健康的潜在可改变的风险因素的三个领域包括：身体活动、心血管风险因素以及心理社会特征和行为。本提案的具体目的是：目的1：评价身体活动（根据运动水平定义）对早期膝关节骨性关节炎事件和进展的影响，预期更多地参与轻度和中度运动具有保护作用;而更多地参与剧烈运动则有害。目的2：研究心血管危险因素对膝关节骨性关节炎的影响，预期它可能是一种动脉粥样硬化性疾病。目的3：研究心理社会风险因素（如疼痛应对策略、自我效能和社会支持）对膝关节骨性关节炎的影响。骨关节炎倡议（OAI）是进行这项拟议研究的理想环境，这是一项公开可用的观察性研究，其中3284例入组发病率队列，该组被选为症状性膝关节OA的高风险组。参与者每年参加5次综合问卷调查，身体评估和标准化膝关节X光检查。目前处于延续阶段，参与者继续每2年进行一次面对面交流，以便有机会要求提供未纳入母研究的其他调查信息。作为一项正在进行的OAI辅助研究的合作研究者和一名使用OAI数据作为主要作者发表了2项研究的研究者，我熟悉这项拟议辅助研究的母研究的设计和实施。因此，我最适合执行这项拟议的研究，该研究将有可能确定新的可改变的风险因素，同时贡献新的数据来丰富这一已经杰出的公开可用资源。我是一名风湿病学家，有一个坚定的职业目标，即成为一名独立的学术研究者，在临床OA研究方面具有专业知识。通过将我的研究兴趣从研究膝关节骨性关节炎中基于成像的决定因素扩展到包括其他临床和基于患者的因素在内的更广泛的方法，我将能够全面研究这种疾病，并且更有可能确定确实可以改变的风险因素。为了实现这一目标，我计划在调查方法，行为干预，研究设计，分析和行为科学研究相关的统计方法方面获得正式培训。这个奖项将使我能够进一步扩大我的知识和技能，使我能够建立一个科学强大的临床研究计划，并确保独立的资金来维持我的研究和指导他人。