Developing an Automated Image Analysis and Finite Element Modeling Platform to Assess the Effects of Supplemental Protein and Weight Loss on Bone Health in Obese Older Adults

项目总结 在过去的几十年里，肥胖症已经上升到流行的比例，现在影响着超过40%的老年人 美国的成年人。虽然故意减肥是治疗严重肥胖症的一种非常有效的方法，但它 相关的合并症，越来越多的证据表明，它破坏骨骼健康，增加骨折风险。 补充蛋白质可能会降低骨质疏松性骨折的风险，并有效地减少骨丢失 与老龄化人口中的有意减肥有关。维克森林医院正在进行的临床试验 该大学正在研究是否在为期6个月的减肥干预中摄入更高的蛋白质，然后再进行12个月的 与推荐蛋白质相比，肥胖老年人的一个月随访结果显示18个月的骨骼健康状况更好 仅在为期6个月的减肥干预期间摄入或更高的蛋白质摄入量。这项建议加强了 通过简化高级3D集合对骨骼健康和骨折预测的父母研究评估 定量CT骨测量和有限元骨强度测量 (Fe)建模。AIM 1将开发一个自动化成像信息学平台，以分析基线、6个月和 18个月的受试者进行CT扫描，测量骨密度(VBMD)和骨皮质厚度 时髦。目标2将使用特定于受试者的有限元模型来评估纵向骨强度并预测骨折。已被占用 总之，这些方法学的进步将提高我们对蛋白质补充剂的理解。 影响骨骼质量。这项分析的结果也可以证明蛋白质补充的合理性。 作为一种临床相关的治疗方法，可以减少老年人的骨丢失和降低骨折风险 减肥。这项研究将在威克森林学校的损伤生物力学中心进行。 医学作为生物医学工程、老年学系之间的跨学科合作 以及老年医学、放射学、生物统计学和数据科学。这一奖学金也将成为一项独特的 对博士前首席研究员进行老年学研究、临床试验设计、 生物统计学、骨代谢生物学、基于图像的信息学和计算生物力学。最终， 该项目将完善首席研究员在图像分析和生物医学工程方面的技能 为应用工程技术改善骨骼健康提供宝贵经验的计算建模 在老年人身上。

PROJECT SUMMARY Over the past several decades, obesity has risen to epidemic proportions and now affects over 40% of older adults in America. While intentional weight loss is a highly effective treatment for severe obesity and its associated comorbidities, increasing evidence suggests it disrupts skeletal health and increases fracture risk. Protein supplementation may reduce osteoporotic fracture risk and be effective in minimizing bone loss associated with intentional weight loss among the aging population. An ongoing clinical trial at Wake Forest University is exploring whether higher protein intake during a 6-month weight loss intervention followed by a 12- month follow-up in obese older adults results in better 18-month bone health compared to recommended protein intake or higher protein intake during the 6-month weight loss intervention only. This proposal enhances the parent study assessment of bone health and fracture prediction by streamlining the collection of advanced 3D bone measures from quantitative computed tomography (CT) and bone strength measures from finite element (FE) modeling. Aim 1 will develop an automated imaging informatics platform to analyze baseline, 6-month, and 18-month participant CT scans to measure volumetric bone mineral density (vBMD) and cortical thickness in the hip. Aim 2 will use subject-specific FE modeling to assess longitudinal bone strength and predict fracture. Taken together, these methodologic advancements will improve our understanding of how protein supplementation affects bone quality. The findings of this analysis could also establish the plausibility of protein supplementation as a clinically relevant therapeutic for attenuating bone loss and mitigating fracture risk in older adults undergoing weight loss. This research will be conducted in the Center for Injury Biomechanics at the Wake Forest School of Medicine as an interdisciplinary collaboration between the Departments of Biomedical Engineering, Gerontology and Geriatric Medicine, Radiology, and Biostatistics and Data Science. This fellowship will also serve as a unique opportunity to train the predoctoral principal investigator in gerontology research, clinical trials design, biostatistics, bone metabolism biology, image-based informatics, and computational biomechanics. Ultimately, the project will refine the principal investigator's biomedical engineering skillset in image analysis and computational modeling to provide valuable experience applying engineering techniques to improve bone health in older adults.