PROSPECTIVE STUDY OF OSTEOPOROSIS & RISK FACTORS IN JRA

这项建议的长期目标是减少骨质减少的风险 幼年类风湿性关节炎（JRA）患者的骨折。 的 实现这一目标的第一步是描述自然历史， 骨疾病的JRA和确定，这些危险因素，预测减少 骨量 预防和治疗艾滋病的干预战略 骨质减少将来自骨骼发育过程中获得的 通过连续测量骨矿物质密度（BMD）。 的 该建议的具体目标是：（1）确定患者是否 与JRA有骨骼生长和发育的速度下降， 将BMD的变化率与儿童对照组进行比较;（2） 确定导致骨密度异常的因素， JRA患者人群的代谢;（3）表征骨 通过连续测量骨的形成和再吸收动力学 成骨细胞和骨细胞活性的生化标志物。 的 将通过以下方式比较JRA患者与对照组的BMD变化： 协方差分析的性能。 假定风险因素的影响 将通过单变量分析和构建 多变量模型 该提案的主要发起人Murray J. Favus博士是一位 在骨代谢和骨疾病领域的杰出研究员。 博士费乌斯将指导拉比诺维奇医生研究骨骼疾病 和骨质疏松症的危险因素。 卡瑞森博士， 二级申办者，是一名生物统计学家，在以下方面具有丰富的经验： 临床研究通过他的研究和他的工作与机构 审查委员会和临床研究中心（CRC）在大学 芝加哥。 Karrison博士将指导Rabinovich博士 数据分析领域的专业知识。 在费沃斯博士的指导下 拉宾诺维奇博士将努力成为一名成功的独立人士 儿科风湿病学和骨骼领域的临床研究者 紊乱 拉比诺维奇博士已经为正式的说教式教学制定了一个大纲 包括参加由CRC赞助的名为“基本知识”的课程 临床研究”，通过参与罗伯特伍兹约翰逊 临床学者计划和生物统计学课程的入学人数 由Karrison博士教授。 这门课会让拉比诺维奇博士 卫生服务研究，医学伦理，研究设计， 生物统计学和结果研究。 此外，拉宾诺维奇博士将出席 每周在加州大学举行一次题为“健康研讨会”的互动研讨会 研究”，并继续积极参加与 骨工作组。 博士拉宾诺维奇的背景和经验总结在传记 草图支持她参与指导临床科学家 发展计划。 拉宾诺维奇博士有独特的能力，包括正式的 通过攻读公共卫生硕士学位进行流行病学培训 在流行病学上。 她在儿科风湿病学， 全面发展的临床医生和教师。 她正在发展专业知识， 骨疾病领域。 她的长期职业规划是追求一个职业生涯 在学术医学，包括临床研究，教学和病人 在乎 指导临床科学家发展奖将帮助博士。 拉宾诺维奇，因为她努力发展成为一个独立的调查员。

The long-term goal of this proposal is to reduce the risk for osteopenia and fracture in patients with juvenile rheumatoid arthritis (JRA). The first steps toward this goal are to characterize the natural history of bone disease in JRA and identify, those risk factors which predict reduced bone mass. Strategies for intervention in the prevention and treatment of osteopenia will be derived from the course of skeletal development obtained through sequential measurements of bone mineral density (BMD). The specific aims of this proposal are; (1) to determine whether patients with JRA have a decreased rate of skeletal growth and development by comparing rates of change in BMD to a control group of children; (2) to identify the factors that contribute to abnormalities in bone density and metabolism in the JRA patient population; (3) to characterize bone formation and resorption dynamics through sequential measurement of bone biochemical markers of osteoblastic and osteoclastic activities. The change in BMD in JRA patients versus controls will be compared by performance of analysis of covariance. The impact of putative risk factors on BMD will be evaluated by univariate analysis and by construction of a multivariable model. The primary sponsor for this proposal, Dr. Murray J. Favus, is an accomplished researcher in the field of bone metabolism and bone diseases. Dr. Favus will guide Dr. Rabinovich in the investigation of bone disorders and risk factors for osteoporosis in patients with JRA. Dr. Karrison, the secondary sponsor, is a biostatistician with extensive experience in clinical studies via his research and his work with the Institutional Review Board and the Clinical Research Center (CRC) at the University of Chicago. Dr. Karrison will guide Dr. Rabinovich as she extends her expertise in the field of data analysis. Under the tutelage of Drs. Favus and karrison, Dr. Rabinovich will strive to become a successful independent clinical investigator in the fields of pediatric rheumatology and bone disorders. Dr. Rabinovich has outlined a plan for formal didactic teaching including enrollment in a course sponsored by the CRC entitled "Essentials of Clinical Research", through participation in the Robert Woods Johnson Clinical Scholars Program and by enrollment in a biostatistics course taught by Dr. Karrison. This coursework will augment Dr. Rabinovich's knowledge in health services research, medical ethics, research design, biostatistics and outcome studies. In addition, Dr. Rabinovich will attend weekly interactive seminars at the U of C entitled "Seminars in Health Studies" and remain an active participant in a series of meetings with the Bone Working Group. Dr. Rabinovich's background and experience summarized in the biographical sketch support her participation in the Mentored Clinical Scientist Development program. Dr. Rabinovich has unique abilities, including formal training in epidemiology through the pursuit of a Master's in Public Health in epidemiology. She is board certified in a pediatric rheumatology, a well rounded clinician and teacher. She is developing expertise in the field of bone disorders. Her long term career plans are to pursue a career in academic medicine encompassing clinical research, teaching, and patient care. The Mentored Clinical Scientist Development Award will aid Dr. Rabinovich as she strives to develop into an independent investigator.