Multicenter Osteoarthritis Study (MOST)

描述(申请人提供)：骨性关节炎(OA)是最常见的 膝关节中的关节炎和疾病是导致残疾的主要原因。 大多数膝骨性关节炎的流行病学研究都集中在放射学疾病上，但 症状性骨性关节炎应该是预防骨性关节炎的主要研究重点，因为 症状性疾病导致残疾，具有强大的社会和公众影响 对健康的影响。骨质疏松症可能是可以预防的，但数量有限。 大多数不可更改的风险因素已被确定，即使是可以更改的 风险因素，如特定活动、肌肉无力、本体感觉 提出了赤字、微量营养素缺乏和结构性因素 并可能在很大程度上影响疾病风险。预防机会是 最相关的，最有可能被那些已经患病的人使用的 或者谁是感染风险最高的人。 这项建议将四种新方法引入到流行性感冒的流行病学研究中。 膝骨性关节炎：L.A专注于症状性疾病，2.全面 评估风险因素，包括可修改的风险因素，3.重点关注那些 将真正从预防机会中受益，那些已经拥有 疾病或那些感染这种疾病的高危人群以及4.成立为 比以前使用的更全面和更可重复性的成像 包括最先进的射线照相技术和核磁共振成像。MRI提供了丰富的 关于结构因素的信息，在这些因素中，异常可能影响 疾病。 这项研究的总体目标是纵向评估这些影响 三组因素：生物力学因素(蹲、跪、楼梯 爬升、股四头肌无力和本体感觉障碍)、骨骼和结构性 因素(MRI上的骨密度、骨髓和半月板病变)和 微量营养素缺乏(维生素C、E和D)的发生和 以人群为基础的膝关节骨性关节炎的症状和放射学进展 年龄在50岁到79岁之间的男性和女性样本。 我们建议招募一个以社区为基础的样本，包括3000名可能 要么患有膝骨性关节炎，要么处于骨性关节炎的高危状态。高危人群将包括 超重者、有膝部症状者或有 膝盖受伤或手术。受试者将根据症状进行评估 问卷、X光片和核磁共振？S将接受为期36个月的随访。 症状性或放射性骨性关节炎的发展或进展。分析将 重点研究这些重要风险因素与骨性关节炎结局的关系。 这项针对膝骨性关节炎患者的大型、多方面和综合性研究 疾病的高风险，提出明确解决与 对重大疾病的发展或进展具有潜在重要风险的因素 使疾病失效，并提供对疾病生物学和 潜在的预防机会

DESCRIPTION (provided by applicant): Osteoarthritis (OA) is the most common form of arthritis and disease in the knee is a leading cause of disability. Most epidemiologic studies of knee OA have focused on radiographic disease, but symptomatic OA should be a major focus of studies on preventing OA, because symptomatic disease causes disability and has formidable societal and public health impacts. OA is potentially preventable, but only a limited number of mostly nonmodifiable risk factors has been identified, even though modifiable risk factors such as particular activities, muscle weakness, proprioceptive deficits, micronutrient deficiencies and structural factors have been proposed and may affect substantially the risk of disease. Prevention opportunities are most relevant and are most likely to be used by those who already have disease or who are at highest risk of getting it. This proposal introduces four new approaches into the epidemiologic study of knee osteoarthritis: l.a focus on symptomatic disease, 2. a comprehensive evaluation of risk factors including modifiable ones, 3. a focus on those who would really benefit from prevention opportunities, those who already have disease or those who are at high risk of getting it and 4. the incorporation of more comprehensive and reproducible imaging than has previously been used including, state of the art radiographic techniques and MRI. MRI provides rich information on structural factors in which abnormalities may affect the risk of disease. The overall objective of this study is to evaluate longitudinally the effects of three groups of factors: biomechanical factors (squatting,kneeling, stair climbing, quadriceps weakness and proprioceptive deficits), boneand structural factors (bone density,bone marrow and meniscal lesions on MRI) and micronutrient deficiencies (vitamin C, E and D) on the occurrence and progression of symptomatic and radiographic knee OA in a population-based sample of men and women aged 50 to 79. We propose to recruit a community-based sample of 3,000 men and women likely to either have knee OA or be at high risk of OA. High risk groups will include those who are overweight, those with knee symptoms or those with a history of knee injuries or operations. Subjects will be evaluated with symptom questionnaires, radiographs and MRI?s and will be followed 36 months for the development or progression of symptomatic or radiographic OA. Analyses will focus on the relation of these important risk factors and OA outcomes. This large, multifaceted and comprehensive study of persons with knee OA, or at high risk of disease, offers to address definitively the relation of potentially important risk factors to the development or progression of a major disabling disease and to provide new insights into disease biology and potential opportunities for prevention