THE PREVALENCE OF LOW BONE DENSITY IN WOMEN WITH NEURGENIC CLAUDICATION

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 背景：骨质疏松症是我们老龄化人口面临的一个主要健康问题。 它是一种骨骼疾病，其特征是骨量减少，导致脆性和骨折。 许多骨骼退行性疾病，如骨关节炎和椎管狭窄，其特征在于局部骨密度增加，这可以掩盖骨量的普遍损失。 骨质疏松症和其他退行性肌肉骨骼疾病之间的关系是未知的，并具有特别的相关性，因为这两种类型的疾病随着年龄的增长而增加。 探索这种关系的第一步是确定退行性疾病（如椎管狭窄）患者低骨密度的患病率。 此外，可以将脊柱中的局部骨密度与其他区域进行比较。 目的：神经源性跛行的存在定义了一组受椎管狭窄症影响的患者。 主要目的是对神经源性跛行受试者进行横断面研究，以确定症状性椎管狭窄（一种常见的中轴骨骼退行性疾病）受试者局部骨密度降低的患病率。 次要目的包括比较脊柱和该组其他区域的骨密度。 这项研究代表了探索退行性肌肉骨骼疾病和骨密度之间关系的更大研究项目的初步步骤。 设计和主题：这是一项前瞻性研究，研究对象是到三级脊柱保健中心评估脊柱问题的女性。 所有50岁以上的妇女都有资格填写我们的标准摄入表格，以了解脊柱问题和骨质疏松症的风险。 将要求诊断为神经源性跛行（症状性椎管狭窄）的患者参加研究。 临床诊断将通过瑞士脊柱狭窄问卷和穿梭行走试验进行确认。 将获得股骨近端、非优势前臂和腰椎的双能X线吸收测定法（DXA）扫描。 血清和尿液标志物将用于测量绝经状态和骨转换。 收集的描述性变量包括年龄、病史、骨质疏松风险因素、自我报告的功能和健康状况以及客观行走能力等。 将使用骨矿物质密度确定是否存在骨质疏松症或低骨量，并在必要时提出治疗建议。 潜在影响：推进脊柱退变研究的能力需要表征共存的骨骼疾病。 如果骨密度变化在椎管狭窄受试者中普遍存在，那么这一人群提供了一个研究机会，以提高我们对活动，骨骼健康和旨在增加体力活动作为肌肉骨骼健康护理组成部分的治疗之间关系的理解。 这些发现也可能有助于确定这一人群中椎管狭窄的病因。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Context: Osteoporosis is a major health issue facing our aging population. It is a bone disease characterized by decreased bone mass leading to fragility and fracture. Many skeletal degenerative disorders like osteoarthritis and spinal stenosis are characterized by local increased bone density, which can mask generalized loss of bone mass. The relationship between osteoporosis and other degenerative musculoskeletal disorders is unknown and has particular relevance as both types of disorders increase with age. A useful first step in exploring this relationship is to establish the prevalence of low bone density in patients with degenerative disorders, like spinal stenosis. Further, regional bone density in the spine can be compared with other areas. Objectives: The presence of neurogenic claudication defines a group of patients who are symptomatically affected by spinal stenosis. The primary aim is to perform a cross-sectional study of subjects with neurogenic claudication to establish the prevalence of regional decreases in bone mineral density in subjects with symptomatic spinal stenosis, a common degenerative disorder of the axial skeleton. Secondary aims include comparisons between the bone density of the spine and those of other regions in this group. This study represents the preliminary steps to a larger research project exploring the relationships between degenerative musculoskeletal conditions and bone density. Design and Subjects: This is a prospective study of a population of women presenting to a tertiary care spine center for evaluation of a spinal problem. All women over 50 are eligible and asked to complete our standard intake forms for both spinal problems and osteoporosis risk. Those diagnosed with neurogenic claudication (symptomatic spinal stenosis) will be asked to participate. The clinical diagnosis will be confirmed with the Swiss Spinal Stenosis Questionnaire and Shuttle Walking Test. Dual-energy x-ray absorptiometry (DXA) scans of the proximal femur, nondominant forearm and lumbar spine will be obtained. Serum and urine markers will be used to measure menopausal status and bone turnover. Descriptive variables collected will include age, medical history, osteoporosis risk factors, self-reported function and health status, and objective ambulatory ability among others. Bone mineral density will be used to determine the presence or absence of osteoporosis or low bone mass and treatment recommendations initiated if necessary. Potential Impact: The ability to move forward with research into spinal degeneration requires characterization of coexisting skeletal disorders. If bone density changes are prevalent in subjects with spinal stenosis then this population offers an opportunity for research to improve our understanding of the relationship between activity, skeletal health, and therapies directed at increasing physical activity as a component of musculoskeletal health care. These findings may also help define the etiology of spinal stenosis in this population.