Ethnic Differences in the Risk of Fracture and Vascular Disease

骨折和血管疾病风险的种族差异

• 批准号: 7924442
• 负责人: JEFFREY R. CURTIS
• 金额: $ 10.8万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-18 至 2011-09-17
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7924442
• 关键词: Address; Adrenergic beta-Antagonists; Adult; African American; Age; American; Ancillary Study; Area; Atherosclerosis; Award; Biology; Blood Vessels; Bone Density; Caring; Caucasians; Caucasoid Race; Chronic; Clinical; Comorbidity; Data; Development; Disease; Education; Enrollment; Epidemiologist; Epidemiology; Ethnic Origin; Event; Exhibits; Fracture; Funding; Future; Gender; Glucocorticoids; Goals; Hand; Health Status; Incidence; Individual; Knowledge; Lead; Link; Longitudinal Studies; Mentored Patient-Oriented Research Career Development Award; Mentors; Modeling; Morbidity - disease rate; Myocardial Infarction; National Institute of Neurological Disorders and Stroke; Osteoporosis; Outcome; Patient Care; Patients; Persons; Pharmaceutical Preparations; Population; Postmenopause; Prevention; Preventive Intervention; Principal Investigator; Prospective Studies; Public Health; Questionnaires; Race; Reasons for Geographic And Racial Differences in Stroke; Recruitment Activity; Recurrence; Relative (related person); Relative Risks; Reporting; Research; Research Design; Research Personnel; Research Proposals; Resources; Rheumatism; Risk; Risk Factors; Sex Characteristics; Spinal Fractures; Stroke; Subgroup; Supervision; Survival Analysis; Techniques; Testing; Training; Training Programs; Variant; Vascular Diseases; Woman; base; bisphosphonate; bone; bone health; career; career development; cohort; design; ethnic difference; experience; hazard; health organization; high risk; improved; insight; male; men; mortality; novel; osteoporosis with pathological fracture; patient population; population based; programs; racial and ethnic; racial/ethnic difference; skills

DESCRIPTION (provided by applicant): The career objective of the K23 candidate is to become a rheumatic disease epidemiologist. In the context of mentored research, Dr. Curtis will examine the incidence, risk factors, and outcomes related to osteoporosis, with an emphasis on African Americans and men. To achieve this objective, Dr. Curtis has designed a didactic training program to augment his methodologic skills in analytic techniques relevant to large longitudinal studies. With supervision of experienced mentors, Dr. Curtis will obtain hands-on training in the conduct and analysis of an ancillary study to the 4 year R01 "Reasons for Geographic and Racial Differences in Stroke" study funded by the NINDS enrolling 30,000 African Americans and Caucasians. Although typically at lower risk for fractures than Caucasian women, African Americans and men suffer greater post-fracture morbidity and mortality. The ability to estimate absolute fracture risk among men and non-Caucasians is limited since these persons are relatively underrepresented in osteoporosis cohorts. Prior fracture appears to be an independent risk for subsequent stroke and myocardial infarction (Ml), but the association between bone and vascular disease in high risk, understudied populations is poorly understood. The specific aims of the K23 project are 1) Define ethnic/racial differences in relative and absolute fracture incidence over 4 years in 3 high risk groups (prevalent fracture; prior stroke; glucocorticoid use) compared to the overall cohort; 2) Determine ethnic/racial differences in stroke and Ml risk among those with prevalent fracture. Survival analysis will compare rates and risk factors for first and recurrent fractures and vascular events by ethnicity/race and gender. Shared risk factors for both bone and vascular disease will be examined in several secondary hypotheses based on an ancillary questionnaire sent to the entire cohort. Data generated from this project will provide a framework for future research proposals. Better understanding of the absolute and relative hazards associated with risk factors for fracture and associated vascular events in African Americans and men may lead to improved understanding of the underlying biology and help reduce ethnic/racial and gender-related disparities in osteoporosis care. Beyond the training objective of this award, the ultimate goal is better prevention through improved identification of those at highest risk for poor outcomes from osteoporotic fractures and associated vascular disease.

描述（由申请人提供）：K23候选人的职业目标是成为一名风湿病流行病学家。在指导研究的背景下，柯蒂斯博士将研究与骨质疏松症相关的发病率、危险因素和结果，重点是非裔美国人和男性。为了实现这一目标，柯蒂斯博士设计了一个教学培训计划，以增强他在与大型纵向研究相关的分析技术方面的方法技能。在经验丰富的导师的监督下，Curtis 博士将获得对为期 4 年的 R01“中风的地理和种族差异的原因”研究的辅助研究进行和分析的实践培训，该研究由 NINDS 资助，招募了 30,000 名非裔美国人和白种人。尽管通常比白人女性骨折的风险较低，但非裔美国人和男性的骨折后发病率和死亡率更高。估计男性和非白人的绝对骨折风险的能力有限，因为这些人在骨质疏松症队列中的代表性相对不足。既往骨折似乎是随后发生中风和心肌梗塞（MI）的独立风险，但在高风险、研究不足的人群中，骨骼与血管疾病之间的关联尚不清楚。 K23 项目的具体目标是 1) 与总体队列相比，确定 3 个高风险群体（常见骨折、既往中风、糖皮质激素使用）4 年来相对和绝对骨折发生率的种族/种族差异； 2) 确定骨折流行人群中中风和 MI 风险的种族/种族差异。生存分析将按种族/种族和性别比较首次和复发性骨折以及血管事件的发生率和危险因素。将根据发送给整个队列的辅助调查问卷，在几个次要假设中检查骨骼和血管疾病的共同危险因素。该项目产生的数据将为未来的研究提案提供框架。更好地了解与非裔美国人和男性骨折危险因素和相关血管事件相关的绝对和相对危险可能会提高对潜在生物学的了解，并有助于减少骨质疏松症治疗中的种族/种族和性别相关差异。除了该奖项的培训目标之外，最终目标是通过更好地识别那些因骨质疏松性骨折和相关血管疾病而导致不良后果的风险最高的人，从而更好地预防。