Sex Differences in Musculoskeletal Conditions across the Lifespan

描述（由申请人提供）：肌肉骨骼疾病是美国初级保健医生就诊的最常见疾病，随着年龄的增长，肌肉骨骼疾病（特别是骨质疏松症和骨关节炎）的发病率在女性中高于男性，并导致大量残疾和生活质量下降。流行病学数据清楚地表明，随着年龄的增长，女性罹患肌肉骨骼疾病的比例高于男性，但这种性别差异的生物学解释仍不清楚。这项跨学科、多机构的提案的目标是“一生中肌肉骨骼状况的性别差异”，是整合骨量峰值生理性别差异的前沿基础科学，骨形态性别差异与骨关节炎发生、严重程度及预后关系的流行病学研究，高分辨率超声性别差异在腕管综合征保守及手术治疗中的诊断及预后临床研究。还有一项随机试验，性别差异对体育活动干预治疗后凸的反应。该专门研究中心的首要目标是为男女患者提供信息和改变诊断和治疗这些肌肉骨骼疾病的预防工作和临床实践，并改善妇女的健康状况。组成该中心的四个项目将通过以下方式进行关键的创新研究，以表征肌肉骨骼疾病的性别差异：1)与调节或影响峰值骨量相关的孕酮受体性别差异的机制研究，2)使用新型诊断技术检查腕管综合征诊断结果的性别差异以及该疾病标准治疗方法的性别差异的前瞻性临床队列研究，3)评估骨形状的性别差异以及骨形状对发育的影响的流行病学影像学研究。膝关节骨性关节炎的严重程度和预后，以及4)对运动干预治疗后凸反应性别差异的随机临床试验。该中心的研究成果将通过中心研究人员在许多不同论坛上的演讲转化为当地和全国医学界的成果，包括加州大学戴维斯分校和加州大学旧金山分校的继续医学教育项目，以及当地的大型查房和全国会议。

DESCRIPTION (provided by applicant): Musculoskeletal Diseases comprise the most frequent ailment for primary care physician visits in the United States, and the increases in incidence of musculoskeletal diseases with aging (particularly osteoporosis and osteoarthritis) is higher in women than in men, and leads to a significant amount of disability and reduced quality of life. Epidemiologic data clearly demonstrate the proportion of women affected my musculoskeletal diseases is higher than in men with aging, yet the biologic explanation for this sex difference remains unclear. The objective of this interdisciplinary, multi-institutional proposal, entitled "Sex Differences in Musculoskeletal Conditions Across the Lifespan," is to integrate cutting-edge basic science regarding sex differences in the physiology relate to acquiring peak bone mass, epidemiologic study on the relation of sex differences in bone shape to occurrence, severity and prognosis of osteoarthritis, clinical study of sex differences in high resolution ultrasound in diagnosis and prognosis of carpal tunnel syndrome with conservative and surgical treatment, and a randomized trial of sex differences in response to a physical activity intervention for kyphosis. The overarching goal of this Specialized Center of Research is to inform and transform preventive efforts and clinical practice in diagnosis and treatment of these musculoskeletal conditions in both sexes and lead to improvements in women's health. The four projects that compose the Center will conduct critical, innovative research to characterize sex differences in musculoskeletal conditions via: 1) a mechanistic study of sex differences in progesterone receptors that are related to regulation or influence peak bone mass, 2) a prospective clinical cohort study using novel diagnostic technology to examine sex differences in the results of this technology to diagnose carpal tunnel syndrome and sex differences in standard treatments for this condition, 3) an epidemiologic imaging study to assess sex differences in bone shape and the influence of bone shape on the development, severity and prognosis of osteoarthritis of the knee, and 4) a randomized clinical trial of sex differences in response to an exercise intervention for the treatment of kyphosis. The Center's research results will be translated to the local and national medical community's through presentations by Center researchers at a number of different forums, including UC Davis and UCSF continuing medical education programs, as well as local grand rounds and national meetings. PUBLIC HEALTH REFERENCE: This translational SCOR grant, "Sex Differences in Musculoskeletal Diseases Across the Lifespan," focuses on four musculoskeletal diseases or syndromes that differ by sex and include peak bone mass (a laboratory based project), carpal tunnel syndrome (epidemiologic and observational), osteoarthritis of the knee (observational), and kyphosis (exercise intervention). Each project will carefully determine the sex differences in relation to the musculoskeletal diseases and inform preventive and clinical practices.