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）很常见， 65岁及以上的残疾人， 直接和间接医疗费用的很大一部分（1 - 13）。 非洲裔美国人可能比高加索人更容易发展活动 关节炎导致的限制和残疾（1，4，12，14 - 19）。先前 然而，膝关节和髋关节OA的流行病学研究几乎完全 仅限于高加索人。1990年开始在北卡罗来纳州的一个乡村县， 约翰斯顿国家骨关节炎项目是一个前瞻性的，人口- 基于研究的膝关节、髋关节和髌股关节（PFJ）OA， 美国人和高加索人（20）。广泛的基线临床，放射学， 收集了研究参与者的功能和血清学数据， OA影像学特征的显著种族差异 注意到（20 - 24）。这项建议旨在重新审视3200研究 参与者，年龄在45岁及以上，平均研究后5年 入组，描述发生率和进展的种族差异 影像学膝关节、髋关节和PFJ OA，OA进展至新关节部位， 膝盖和臀部疼痛以及功能性残疾。高危亚组 将确定这些成果。1）肥胖，2）代谢 和共病心血管因素，以及3）饮食因素，包括 欧米茄-3和欧米茄-6脂肪酸和抗氧化微量营养素， 作为这些结果的潜在风险因素进行纵向检查， 每个民族。饮食数据将来自计算机辅助饮食 接受问卷调查和广泛、高度详细的基线分析 14类胡萝卜素和生育酚的血清。分层分析和多重 logistic和多分类logistic回归，广义估计 在适当的情况下，将使用方程式评估种族差异， 这些因素在上述结果中的作用。通过检查角色 这些因素在两个种族的OA过程的多个方面， 学习、效率和信息量相同的群体 可以最大化单位成本。

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.