RA Comorbidity Bone Health in Men and African Americans

男性和非裔美国人的 RA 合并症骨骼健康

• 批准号: 6944873
• 负责人: TED RICHARD MIKULS
• 金额: $ 10.06万
• 依托单位: UNIVERSITY OF NEBRASKA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-08-27 至 2009-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6944873
• 关键词: African American; alleles; bone density; clinical research; comorbidity; disease /disorder proneness /risk; femur; gender difference; gene environment interaction; glucocorticoids; hip; hormone therapy; human subject; longitudinal human study; male; medical complication; osteopenia; osteoporosis; pathologic process; photon absorptiometry; racial /ethnic difference; rheumatoid arthritis; vertebrae; women' s health

DESCRIPTION (provided by applicant): Dr. Mikuls' career goals are to participate in meaningful investigations of the epidemiology and outcomes of musculoskeletal disorders and in the process develop an independent career in clinical research with consistent NIH funding. In order to meet his immediate and long-term objectives, the applicant has proposed a career development plan that relies predominantly on hands-on research experience with cohort design, management, and analysis. Didactic training will include seminars and face-to-face mentoring sessions with experienced NIH-funded investigators. The career development training will cover areas that are directly pertinent to the proposed research project. This project includes cross-sectional and prospective evaluations of patients with RA participating in the NIH-funded Consortium for the Longitudinal Evaluation of African- Americans with eady Rheumatoid Arthritis (CLEAR) the VA Rheumatoid Arthritis (VARA) registries. The aims of the study are: 1) to determine baseline lumbar spine and femoral neck bone mineral density (BMD) values and osteopenia / osteoporosis prevalence among AA patients with early RA and among male veterans with established disease and, 2) to identify environmental factors and candidate alleles, which confer increased risk of reduced baseline BMD and BMD loss over time among AA patients with early RA and among male veterans with established disease. Subjects will undergo bone mineral density (BMD) measurement of the femur and lumbar spine via duel energy x-ray absorptiometry at the time of enrollment and again after a standard period of follow-up (2 years for VARA, 3 to 5 years for CLEAR). Baseline BMD measurements will be compared in a cross-sectional manner with normative data from the National Health and Nutrition Examination Survey (NHANES) III and from Hologic, Inc. Longitudinal comparisons in BMD will be made among post-menopausal AA women with IRA with data from the prospective Women's Health Initiative (WIll). Using mulitvadable modeling we will examine the role of candidate alleles and environmental factors (particularly glucocorticoid use) as determinants of BMD and BMD loss. This cohort study will greatly enhance our understanding of RA-associated bone loss in traditionally understudied populations and will provide an optimal context for Dr. Mikuls' continued development as an independent clinical investigator.

描述（由申请人提供）： Mikuls 博士的职业目标是参与对肌肉骨骼疾病的流行病学和结果的有意义的调查，并在此过程中在 NIH 持续资助的临床研究中发展独立的职业生涯。为了实现其近期和长期目标，申请人提出了一个职业发展计划，该计划主要依赖于队列设计、管理和分析方面的实践研究经验。教学培训将包括由 NIH 资助的经验丰富的研究人员参加的研讨会和面对面的指导课程。职业发展培训将涵盖与拟议研究项目直接相关的领域。该项目包括对参与 NIH 资助的非裔美国人早期类风湿关节炎纵向评估联盟 (CLEAR) 和 VA 类风湿关节炎 (VARA) 登记的 RA 患者进行横断面和前瞻性评估。该研究的目的是：1) 确定患有早期 RA 的 AA 患者和患有既定疾病的男性退伍军人的基线腰椎和股骨颈骨矿物质密度 (BMD) 值以及骨质减少/骨质疏松患病率，2) 确定环境因素和候选等位基因，随着时间的推移，患有早期 RA 的 AA 患者和患有既定疾病的男性退伍军人的基线 BMD 降低和 BMD 损失的风险增加。受试者将在入组时以及标准随访期后（VARA 为 2 年，CLEAR 为 3 至 5 年）通过双能 X 射线骨密度测定法对股骨和腰椎进行骨矿物质密度 (BMD) 测量。 ）。基线 BMD 测量值将以横断面方式与国家健康和营养检查调查 (NHANES) III 以及 Hologic, Inc. 的规范数据进行比较。将在患有 IRA 的绝经后 AA 女性中进行 BMD 纵向比较来自未来的妇女健康倡议 (WIll)。使用多值模型，我们将检查候选等位基因和环境因素（特别是糖皮质激素的使用）作为 BMD 和 BMD 损失决定因素的作用。这项队列研究将极大地增强我们对传统研究人群中与 RA 相关的骨质流失的理解，并将为 Mikuls 博士作为独立临床研究者的持续发展提供最佳背景。