OSTEOPOROSIS IN MEN

长期以来，人们已经认识到骨质疏松症对女性的重要性，几十年的研究已经产生了坚实的机械和实用知识基础，这些知识是临床决策的基础。另一方面，指导男性骨质疏松症治疗的信息很少。这项研究(MR.OS)的主要目标是确定男性骨折风险与骨量、骨骼几何形状、生活方式因素、生化指标、跌倒倾向和其他变量的关系程度。这些信息对于了解骨折的起源以及制定检测和治疗男性骨质疏松症的临床算法是必不可少的。第二个目标是确定骨质疏松性骨折与老年男性前列腺癌和骨关节炎(OA)两种常见慢性病之间的关系。这将是一项关于老年男性(65岁)椎骨和所有非椎体骨折风险因素的多中心前瞻性研究。总共将在六个不同的地理区域(俄勒冈州波特兰、匹兹堡、明尼阿波利斯、圣地亚哥、帕洛阿尔托和伯明翰)招募5700名男性，并将平均跟踪三年。基线评估将包括骨密度和骨几何、椎体形态测量、骨关节炎、神经肌肉和视觉功能、人体测量学、营养、病史、用药情况、血清/尿液/DNA采集和功能状态。将在两次后续访问中获得骨密度和健康/功能状态的重复测量。期末检查将包括脊柱、臀部和膝盖的重复X光片，以确定脊椎骨折发生率，以及骨性关节炎的发生率和进展。参与者将每4个月通过明信片进行跟踪，以确定非脊椎骨折、跌倒和前列腺癌的发生率。数据分析将利用比例风险和Logistic回归模型，具体取决于所分析的结果类型。这项研究将有90%的能力检测脊椎骨折的RR为1.35，非脊柱骨折的OR为1.22。MR.OS将提供有关骨质疏松症和其他常见疾病的独特信息，并将为建立关键的预防和治疗战略提供基础。

There has long been an appreciation of the importance of osteoporosis in women, and decades of research have yielded a strong foundation of mechanistic and practical knowledge that underlies clinical decision- making. On the other hand, very little information is available to direct the management of osteoporosis in men. The primary goal of this study (MR.OS) is to determine the extent to which fracture risk in order men is related to bone mass, bone geometry, lifestyle factors, biochemical measures, fall propensity, and other variables. This information is essential for understanding the genesis of fractures, and for the formulation of clinical algorithms for detection and treatment of osteoporosis in men. A second goal is to determine the relationships between osteoporotic fracture and two common chronic conditions in older men prostate cancer and osteoarthritis (OA). This will be a multicenter, prospective study of risk factors for vertebral and all non- vertebral fractures in older men (> 65 years). A total of 5,700 men will be recruited in six diverse geographical areas (Portland, OR; Pittsburgh; Minneapolis; San Diego; Palo Alto; and Birmingham), and will be followed for an average of three years. Baseline assessments will include BMD and bone geometry, vertebral morphometry, OA, neuromuscular and visual function, anthropometrics, nutrition, medical history, medication use, serum/urine/DNA collections, and functional status. Repeat measures of BMD and health/functional status will be obtained at two follow-up visits. The final exam will include repeat radiographs of the spine, hips and knees to determine incident vertebral fracture rate, and incidence and progression of OA. Participants will be followed every 4 months by postcard to determine the rates of non-vertebral fracture, falls, and prostate cancer. Data analysis will utilize proportional hazards and logistic regression models, depending on the type of outcome being analyzed. The study will have 90% power to detect RR of 1.35 for vertebral fractures and OR of 1.22 for non-spine fractures. MR.OS will provide unique information concerning osteoporosis and other common disorders, and will provide a basis for the construction of crucial preventative and treatment strategies.