Long term fracture risk and change in peripheral bone in the oldest old men: The MrOS study

最年长男性的长期骨折风险和周围骨变化：MrOS 研究

• 批准号: 10413238
• 负责人: MARY L BOUXSEIN
• 金额: $ 320.28万
• 依托单位: CALIFORNIA PACIFIC MED CTR RES INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-30 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10413238
• 关键词: Address; Age; Aged, 80 and over; Aging; Bone Density; Bone structure; Cessation of life; Clinical; Cohort Studies; Collection; Communication; Data; Data Coordinating Center; Data Discovery; Dual-Energy X-Ray Absorptiometry; Elderly; Enrollment; Fracture; Funding; Future; Goals; Hip Fractures; Hip region structure; Infrastructure; Knowledge; Life; Measurement; Measures; Morbidity - disease rate; Musculoskeletal; Participant; Peripheral; Phase; Phenotype; Prospective Studies; Publications; Research Personnel; Resources; Risk Factors; Scanning; Source; Structure; Vertebral column; X-Ray Computed Tomography; base; bone; bone imaging; bone strength; clinical phenotype; clinical research site; cohort; cost; design; falls; follow-up; fracture risk; health assessment; human very old age (85+); improved; men; mortality; novel; older men; osteoporosis with pathological fracture; scientific organization; skeletal

ABSTRACT Fractures and resulting morbidity, mortality and costs are a large and growing burden among older men. The fracture rate increases exponentially after age 65, and the average age of hip fracture is >80 yrs. Fracture risk in later life is strongly influenced by long term declines in bone density, structure and strength, and during this period skeletal change accelerates. The Osteoporotic Fractures in Men Study (MrOS) is an ongoing, prospective study of risk factors for osteoporotic fractures in older men. The study continues to follows men who were initially enrolled in 2000-2. MrOS is best phenotyped cohort of the oldest men – now in the 9th and 10th decades of life – when fractures are a major threat to maintaining independence. More than 20 years ago, we began to obtain serial DXA measures and complete clinical phenotyping. At baseline, hip and spine CT scans (N=3695) were obtained to assess bone structure and strength. Similarly, HR-pQCT (XtremeCTII) scans were obtained in a large number of men (N=1831) in 2014-6. Thus, MrOS remains the unique source of data and discoveries about musculoskeletal aging in men, and is uniquely suited to address several key clinical and mechanistic knowledge gaps regarding skeletal fragility in older men. The study’s comprehensive bone imaging, its long follow-up and the very old age of the cohort provide unparalleled opportunities to generate novel information needed to design effective approaches to reduce the burden of fractures in older men. The overarching goal of this project is to provide continuity in the organization of the study, continue the infrastructure for the MrOS project, allow for continued follow-up of the participants, and support the collection of limited study measurements. The specific aims of this project are to support the ongoing MrOS infrastructure. These include to 1) continue follow-up for MrOS participants for fractures, falls, mobility limitation and death; 2) collect repeat HR-pQCT scans in a subset of active MrOS participants; and 3) maintain the scientific organization for study communications; publications and ancillary review; and the public data release infrastructure. These aims will provide the critical framework required to address future scientific goals, such as characterization of the circumstances of fractures in the oldest old; quantification of change in peripheral bone microarchitecture by HR-pQCT and identification of determinants of that change; and determination of the utility of hip and spine CT based CT-FEA measures to predict fracture risk in older men.

抽象的 骨折及其导致的发病率、死亡率和费用对于高龄男性来说是一个巨大且日益严重的负担，65 岁后骨折率呈指数级增加，髋部骨折的平均年龄 >80 岁。老年骨折风险受到长期影响。骨密度、结构和强度下降，在此期间骨骼变化加速。 男性骨质疏松性骨折研究 (MrOS) 是一项针对老年男性骨质疏松性骨折危险因素的持续性前瞻性研究，该研究继续追踪 2000 年 2 月首次入组的男性，该研究是最年长男性的表型队列。现在是九十岁和十岁，此时骨折是维持独立的主要威胁。 20 多年前，我们开始获得系列 DXA 测量和完整的临床表型。 在基线时，进行了髋部和脊柱 CT 扫描 (N=3695)，以评估骨骼结构和强度，同样，在 2014 年 6 月对大量男性 (N=1831) 进行了 HR-pQCT (XtremeCTII) 扫描。 ，MrOS 仍然是有关男性肌肉骨骼衰老的数据和发现的独特来源，并且特别适合解决有关骨骼脆弱性的几个关键临床和机械知识差距该研究的全面骨成像、长期随访以及队列的高龄为产生设计有效方法以减轻老年男性骨折负担所需的新信息提供了无与伦比的机会。 该项目的总体目标是提供研究组织的连续性，继续 MrOS 项目的基础设施，允许持续跟踪参与者，并支持收集有限的研究测量结果。 该项目的具体目标是支持正在进行的 MrOS 基础设施，包括 1) 继续跟踪 MrOS 参与者的骨折、跌倒、活动受限和死亡情况；2) 收集活跃 MrOS 子集中的重复 HR-pQCT 扫描。参与者；3) 维护研究交流的科学组织；以及公共数据发布基础设施。 这些目标将为实现未来的科学目标提供关键框架，例如通过 HR-pQCT 来表征老年人的骨折情况；通过 HR-pQCT 量化周围骨微结构的变化，并确定该变化的决定因素；基于髋部和脊柱 CT 的 CT-FEA 测量的实用性可预测老年男性的骨折风险。