OSTEOARTHRITIS OF THE KNEE AND HIP IN JOHNSON COUNTY

膝关节和髋关节的症状性骨关节炎(OA)是常见的，以 65岁及以上老年人的残疾原因，并负责 用于很大比例的直接和间接保健费用(1-13)。 非裔美国人可能比高加索人更有可能开展活动 关节炎的限制和残疾(1，4，12，14-19)。上一首 然而，膝关节和髋关节骨性关节炎的流行病学研究几乎完全 仅限于高加索人。始于1990年，在北卡罗来纳州的一个农村县。 约翰斯顿乡村骨关节炎项目是一个潜在的人群- 基于对两个非洲人的膝关节、髋关节和髌股关节(PFJ)骨关节炎的研究 美国人和高加索人(20)。广泛的基线临床、放射学检查， 已经收集了研究参与者的功能和血清学数据， 在骨性关节炎的放射学特征上存在显著的种族差异 已记下(20-24)。这项提案旨在重新审查3200项研究 参与者，年龄在45岁及以上，研究后平均5年 条目，描述发病和进展的种族差异 膝关节、髋关节和全膝关节骨性关节炎的X线片，骨性关节炎向新的关节部位的进展， 膝盖和臀部疼痛，以及功能残疾。高危亚群 这些结果将被确定。肥胖的作用，2)代谢 和共病心血管因素，以及3)饮食因素，包括 Omega-3和omega-6脂肪酸以及抗氧化微量营养素 被纵向检查为这些结果的潜在风险因素 每一个民族。饮食数据将来自计算机辅助饮食 吸纳问卷和对基线的广泛、高度详细的分析 14种类胡萝卜素和生育酚的血清。分层分析与多重 具有广义估计的Logistic回归和多分类Logistic回归 在适当的情况下，方程式将被用来评估 这些因素在上述结果中的作用。通过检查角色 这些因素在两个民族的办公自动化进程的多个方面 具有相同学习、效率和信息量的小组 获得的单位成本可以最大化。

Symptomatic osteoarthritis(OA) of the knee and hip is common, the leading cause of disability among those 65 years of age and older, and responsible for a large proportion of direct and indirect health costs (1-13). African-Americans may be more likely than Caucasians to develop activity limitation and disability from arthritic (1,4,12,14-19). Previous epidemiologic studies of knee and hip OA, however, have almost exclusively limited to Caucasians. Begun in 1990 in a rural county in North Carolina, the Johnston Country Osteoarthritis Project is a prospective, population- based study of knee, hip, and patellofemoral (PFJ) OA in both African- Americans and Caucasians (20). Extensive baseline clinical, radiographic, functional, and serologic data have been collected on study participants, and significant ethnic differences in radiographic features of OA have been noted (20-24). This proposal aims to re-examine the 3200 study participants, aged 45 years and older an average of 5 years after study entry, to describe ethnic differences in incidence and progression of radiographic knee, hip, and PFJ OA, progression of OA to new joint sites, knee and hip pain, and functional disability. Subgroups at high risk for these outcomes will be identified. The roles of 1) obesity, 2) metabolic and co-morbid cardiovascular factors, and 3) dietary factors, including omega-3 and omega-6 fatty acids and anti-oxidant micronutrients, will be examined longitudinally as potential risk factors for these outcomes in each ethnic group. Dietary data will derive from computer-assisted dietary intake questionnaires and extensive, highly detailed analysis of baseline sera for 14 carotenoids and tocopherols. Stratified analysis and multiple logistic and polytomous logistic regression, with generalized estimating equations when appropriate, will be used to assess ethnic differences in the roles of these factors in the above outcomes. By examining the roles of these factors in multiple aspects of the OA process in both ethnic groups with the same study, efficiency and the amount of information obtained per unit cost can be maximized.