Osteoporotic Fractures in Men - MrOS Renewal

描述（由申请人提供）：男性骨质疏松性骨折（MrOS）研究主要是为了量化男性骨折的决定因素。重要的是，MrOS队列还提供了一个开创性的机会，研究男性在生命的关键时期的进展，其中衰老问题仍然知之甚少。在2000-2002年，从美国6个不同的社区招募了5995名年龄在65岁及以上（平均年龄：基线时72岁）的社区居住男性。经过5年的随访，参与者保持良好（99%的存活者保持活跃）。我们建议进行一次新的门诊访视，并继续随访该队列，以扩大我们对福尔斯、骨折（特别是髋部骨折）和其他衰老后果的风险因素的理解。在基线时，获得面积（来自DXA）和体积（来自QCT）骨骼评估。我们建议在计划的访视中重复相同的评估，以确定髋部骨折的密度测定和生物力学风险因素，以及表征骨骼脆弱性的骨几何结构变化。此外，我们将使用QCT扫描通过有限元建模（FEM）量化股骨强度，并评估FEM对骨折预测的有用性。队列的额外随访和肌肉力量的重复测量（握力、腿部力量）、身体表现（步态速度，椅子站立和狭窄的步行），和自我报告的身体活动将使我们能够建立活动和身体表现变化的程度和性质，确定这些变化的生物学预测因子，并阐明了身体活动和身体表现对骨折风险的可能联合影响。为了客观地量化身体活动，我们建议在新的诊所访视时获得加速度测量。使用基线时存档的血清，我们将检验肾功能、维生素D、甲状旁腺激素对骨骼健康、身体功能和骨折风险有重要影响的假设，并将确定较低的性类固醇水平是否会增加男性骨骼恶化和骨折、身体功能下降和生活质量恶化的风险。结合已经收集的大量数据和生物标本，MrOS队列中的额外措施和延长随访使我们能够扩大对髋部骨折（男性最具破坏性的骨折类型）的理解，并解决对美国老年男性具有强制性公共卫生和临床重要性的其他健康问题。

DESCRIPTION (provided by applicant): The Osteoporotic Fractures in Men (MrOS) study was formed primarily to quantify the determinants of fracture in men. Importantly, the MrOS cohort also provides a seminal opportunity to study men as they progress through a critical period of life in which problems of aging remain poorly understood. In 2000-2002, 5995 community-dwelling men ages 65 years and older (mean age: 72 years at baseline) were enrolled from 6 diverse US communities. After 5 years of follow-up, participant retention is excellent (99% of those alive remain active). We propose a new clinic visit and continued follow-up of the cohort to expand our understanding of risk factors for falls, fractures (particularly hip fracture) and other consequences of aging. At baseline, both areal (from DXA) and volumetric (from QCT) skeletal assessments were obtained. We propose to repeat the same assessments in the planned visit to identify the densitometric and biomechanical risk factors for hip fracture, as well as to characterize bone geometry changes that underlie skeletal fragility. Further, we will use the QCT scans to quantify femoral strength by finite element modeling (FEM), and assess the usefulness of FEM for fracture prediction. Additional follow-up of the cohort and repeat measures of muscle strength (grip strength, leg power), physical performance (gait speed, chair stands, and narrow walk), and self-reported physical activity will enable us to establish the extent and nature of change in activity and physical performance, identify biological predictors of these changes, and clarify the possibly joint effects of physical activity and physical performance on fracture risk. To objectively quantify physical activity we propose to obtain accelerometry measures at the new clinic visit. Using serum archived at baseline, we will test the hypothesis that renal function, vitamin D, parathyroid hormone have important effects on skeletal health, physical function and fracture risk, and will determine if lower sex steroid levels increase men's risk of skeletal deterioration and fracture, decline in physical function, and deterioration in quality of life. Combined with the considerable data and biologic specimens already collected, additional measures and extended follow-up in the MrOS cohort allows us to expand the understanding of hip fractures, the most devastating type of fracture in men, as well as address other health issues of compelling public health and clinical importance to older US men.