OSTEOPOROTIC FRACTURES IN MEN

长期以来，人们一直认识到骨质疏松症在女性中的重要性，几十年的研究已经为临床决策提供了坚实的机制和实践知识基础。另一方面，很少有信息可用于指导管理骨质疏松症的男性。本研究（MR.OS）的主要目的是确定男性骨折风险与骨量、骨几何形状、生活方式因素、生化指标、跌倒倾向和其他变量的关系程度。这一信息对于了解骨折的发生，以及制定男性骨质疏松症的检测和治疗的临床算法至关重要。第二个目标是确定老年男性骨质疏松性骨折与前列腺癌和骨关节炎（OA）两种常见慢性疾病之间的关系。这将是一项多中心的前瞻性研究，研究老年男性（50 ~ 65岁）椎体骨折和所有非椎体骨折的危险因素。总共5700名男性将从六个不同的地理区域（波特兰，俄勒冈州，匹兹堡，明尼阿波利斯，圣地亚哥，帕洛阿尔托和伯明翰）招募，平均随访时间为三年。基线评估将包括骨密度和骨骼几何、椎体形态测量、OA、神经肌肉和视觉功能、人体测量、营养、病史、药物使用、血清/尿液/DNA收集和功能状态。在两次随访中重复测量骨密度和健康/功能状态。期末检查将包括脊柱、髋关节和膝关节的重复x线片，以确定椎体骨折发生率，以及OA的发病率和进展情况。参与者将每4个月通过明信片进行随访，以确定非椎体骨折、跌倒和前列腺癌的发生率。根据分析结果的类型，数据分析将利用比例风险和逻辑回归模型。该研究将有90%的概率检测到椎体骨折的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，并将为构建关键的预防和治疗策略提供基础。

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.